# Successful Management of Angiostrongylus Cantonensis-Induced Eosinophilic Meningitis Using Albendazole–Corticosteroid Therapy: A Case Report With Serial Cytokine and CSF Monitoring

## TL;DR

A case of parasitic meningitis caused by Angiostrongylus cantonensis was successfully treated with albendazole and corticosteroids, showing reduced inflammation and improved outcomes.

## Contribution

This case report provides clinical evidence supporting the effectiveness of albendazole–corticosteroid therapy in managing eosinophilic meningitis.

## Key findings

- The patient showed a significant reduction in inflammatory cytokines and eosinophilic cells after 46 days of treatment.
- Next-generation sequencing confirmed Angiostrongylus cantonensis as the causative agent in this case.
- Combination therapy with albendazole, corticosteroids, and supportive care led to a favorable prognosis.

## Abstract

Angiostrongylus eosinophilic meningitis is aparasitic disease caused by Angiostrongylus cantonensis. The initial report is originated from southern China. However, the incidence rate has decreased due to improvements in sanitary conditions. Individuals who become infected are considered accidental cases. The clinical symptoms exhibit variability, with eosinophilic meningitis accompanied by elevated intracranial pressure being the most prevalent clinical presentation. The main treatment for angiostrongylus eosinophilic meningitis involves giving a combination of albendazole and corticosteroids. In this report, we present a prototypical case of eosinophilic meningitis and confirm Angiostrongylus cantonensis as the causative pathogen through next-generation sequencing (NGS). The disease progression was monitored using a range of blood and cerebrospinal fluid (CSF) assays. The patient underwent an extensive 46-day systemic treatment, resulting in a remarkable reduction of inflammatory cytokines and eosinophilic cells. The combined therapy of albendazole and corticosteroids, along with dehydration management and neuroprotective measures, resulted in positive outcomes. The timely detection and prompt initiation of anthelmintic therapy are associated with a favorable prognosis. This successful experience provides valuable insights for clinical practice.