Clinical Features:
Clinical symptoms of eosinophilic meningitis are caused by the presence of larvae in the brain and by local host reactions.  Symptoms include severe headaches, nausea, vomiting, neck stiffness, seizures, and neurologic abnormalities.  Occasionally, ocular invasion occurs.  Eosinophilia is present in most of cases.  Most patients recover fully.  Abdominal angiostrongyliasis mimics appendicitis, with eosinophilia.

Laboratory Diagnosis:
In eosinophilic meningitis the cerebrospinal fluid (CSF) is abnormal (elevated pressure, proteins, and leukocytes; eosinophilia).  On rare occasions, larvae have been found in the CSF.  In abdominal angiostrongyliasis, eggs and larvae can be identified in the tissues removed at surgery.

Diagnostic findings

• Microscopy
• Morphologic comparison with other intestinal parasites

Treatment:
No drug has proven to be effective for the treatment of A. cantonensis or A. costaricensis infections.  Relief of symptoms for A. cantonensis infections can be achieved by the use of analgesics, corticosteroids, and careful removal of the cerebral spinal fluid at frequent intervals.  For additional information, see the recommendations in The Medical Letter (Drugs for Parasitic Infections).