# Gnathostoma infection after ingestion of raw fish is a probable cause of eosinophilic meningitis in the Brazilian Amazon

## TL;DR

A man in the Brazilian Amazon likely developed brain inflammation after eating raw fish infected with Gnathostoma parasites.

## Contribution

This is the first report linking Gnathostoma infection to eosinophilic meningitis in Latin America.

## Key findings

- A 36-year-old man developed meningitis with high eosinophil levels after eating raw fish.
- Anti-Gnathostoma antibodies were detected, and the patient recovered with corticosteroids and albendazole.
- Another person who ate raw fish developed skin symptoms consistent with gnathostomiasis.

## Abstract

We report a case of eosinophilic meningitis associated with the ingestion of raw fish (Cichla sp.) from the Brazilian Amazon, likely caused by Gnathostoma. A 36-year-old male visited Juruena river on a fishing trip. After 50 days, the patient presented with an intense frontal headache. A cerebrospinal fluid examination revealed 63% eosinophilia. Another individual who ingested raw fish developed linear dermatitis on the abdominal wall. Anti-Gnathostoma serum antibodies were detected, and the patient made a full recovery after treatment with corticosteroids and albendazole. To date, autochthonous Gnathostoma spp. infections in Latin American countries have only caused linear panniculitis. This report raises awareness of gnathostomiasis-causing meningitis.