Voichita Ianas, MD

The case concerns a patient with eosinophilic meningitisattributed to the helminthic parasite Angiostrongyluscantonensis. Before the onset of illness, our patient had ahistory of travel to Hawaii, the only area in the United Stateswhere A cantonensis is endemic. Finding eosinophils in thecerebrospinal fluid (CSF) can narrow the differential diagnosisin a patient with meningitis. In our patient, the proportion ofeosinophils in the CSF was 55%. The case is unique because thepatient was a strict vegetarian. This infection usually developsin persons who inadvertently ingest snails or slugs that containthe parasite. [Infect Med. 2008;25:366-368]