Case Report: Angiostrongylus cantonensis Meningoencephalitis in a 9-Month-Old Baby in Vietnam

Abstract

Meningoencephalitis is not a rare disease in small children. However, eosinophilic meningitis due to <i>Angiostrongylus cantonensis</i> is unusual in a baby. We describe the case of a 9-month-old baby from North Vietnam with eosinophilic meningoencephalitis. The baby lived in a rural area, where farming is widespread, and presented with fever and seizures. Laboratory results showed peripheral eosinophilia (16.1%), cerebrospinal fluid (CSF) white blood cell count 220/mm³ (26% eosinophils), CSF antibody test positive for <i>Ascaris</i>, CSF ELISA positive for <i>Angiostrongylus cantonensis</i>, and blood ELISA positive for <i>A. cantonensis</i>. A mobile worm was identified in the CSF. The presentation was consistent with a diagnosis of <i>A. cantonensis</i> eosinophilic meningitis. The baby recovered fully after administering albendazole (200 mg/day for 2 weeks), and intravenous dexamethasone (0.6 mg/kg/day every 8 hours) and mannitol (1.5 g/kg/day every 8 hours) for the first 3 days, followed by 5 days of oral prednisolone (2 mg/kg/day).