University of Wisconsin–Madison Medical College of Wisconsin

Rapid Therapeutic Response of Eosinophilic Meningoencephalitis in a Toddler With Baylisascaris procyonis Infection

Grace N. Muganda, MD; Naomi E. Akagi, BA; Olufisayo D. Fagbemi, BS; Michael J. Chusid, MD; Anika M. Nelson, MD

WMJ. 2018;117(3):130-132.

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Introduction: Eosinophilic meningitis is an infrequently encountered condition. Baylisascaris procyonis (raccoon roundworm) infection, rarely diagnosed in North America, is a known cause of eosinophilic meningitis, often producing death or permanent neurologic damage.

Case Report: We recently encountered a toddler with geophagia and probable exposure to raccoon feces, who presented with eosinophilic meningitis and encephalitis, and was diagnosed with B procyonis infection and possible Toxocara co-infection. His marked peripheral eosinophilia and neurologic symptoms rapidly responded to corticosteroid and albendazole therapy.

Discussion: Since B procyonis infection is infrequently encountered, its diagnosis in the proper clinical and epidemiologic setting may not always be considered, resulting in a delay of appropriate therapy. Our patient, diagnosed and treated early in his course, demonstrated rapid clinical and laboratory improvement with anti-inflammatory and antiparasitic therapy.

Conclusion: In cases of eosinophilic meningitis, infection with B procyonis should be routinely considered to allow timely institution of effective therapy for this unusual but potentially fatal or debilitating infection.

Author Affiliations: Hospital Medicine (Nelson), Infectious Disease (Chusid), Pediatrics (Muganda, Akagi, Fagbemi), Medical College of Wisconsin and Children’s Hospital of Wisconsin, Milwaukee, Wis.
Corresponding Author: Michael J. Chusid MD, Department of Pediatrics, Children’s Hospital of Wisconsin, PO Box 1997, Milwaukee, WI, 53201-1997; phone 414.337.7070; fax 414.337.7093; email
Funding/Support: None declared.
Financial Disclosures: None declared.
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