EOSINOPHILIC MENINGITIS IN REUNION AND MA YOTTE ISLANDS CAUSED BY ANGIOSTRONGYLUS-CANTONENSIS - 3 CASES IN INFANCY INCLUDING ONE WITH FATALRADICULOMYELOENCEPHALITIS AND HYDROCEPHALUS

Background. - Eosinophilic meningitis caused by Angiostrongylus canton ensis is widespread in Southeast Asia and Pacific Islands. Adults deve lope a transient meningitis with a benign course but severe or fatal d isease may occur in pediatric patients. Case report. - Case 1. A 11-mo nth-old boy living in Mayotte island was hospitalized a few days with fever and skin rash following by seizure, coma, flaccid quadraplegia, absence of deep tendon reflexes, urinary retention and anal incontinen ce. Eosinophilia was observed in peripheral blood and cerebrospinal fl uid. He further developed a triventricular hydrocephalus treated by ve ntriculoperitoneal shunt. The child died 3 weeks later. A serodiagnosi s of angiostrongylus infestation was restrospectively established. Cas e reports 2 and 3. - Two infants, 10 and 11-month-old boys, living in Reunion island, developed fever and vomitings, irritability and, for o ne of them, unilateral sixth cranial nerve palsy. There was eosinophil ia in the peripheral blood and in the cerebrospinal fluid. All symptom s progressively disappeared with complete recovery. The suspected diag nosis of angiostrongylus infestation was confirmed by the serology. Co nclusion. - We report the first case of Angiostrongylus cantoensis inf ection in the French island of Mayotte (Comoro Islands) and we confirm the presence of this disease in Reunion island. In this Indian Ocean area, eosinophilic meningitis occurs most of the time in infants with sometimes severe radiculomyeloencephalitic forms.