Severe Angiostrongylus eosinophilic meningitis in Mayotte island. Report of 3 cases in infants.

Background. Eosinophilic meningitis caused by Angiostrongylus cantonensis i s widespread in Southeast Asia and the Pacific islands. Adults develop tran sient meningitis with a benign course, whilst severe or fatal disease may o ccur in pediatric patients. Case reports. Three infant girls, aged 8 to 11 months, living on the island of Mayotte, developed fever hypotonia, coma (2 cases), and, for one of the m seizures. Eosinophilia was detected in the peripheral blood and cerebrosp inal fluid Secondary flaccid quadraplegia (1 case) or paraplegia (2 cases) with absence of deep tendon reflexes, urinary retention and anal incontinen ce were noted. Three patients had autonomic dysfunction. Computerized tomog raphy showed enlarged ventricles and cerebral subarachnoid spaces. One pati ent had sequelae. Two patients could not be followed. Retrospectively the d iagnosis of angiostrongylus infection was established for two infants by a serological study. Conclusion. We report three new cases of infants with severe Angiostrongylu s cantonensis infection in the French island of Mayotte (Comoro Islands). I n this Indian Ocean area, eosinophilic meningitis seems to occur exclusivel y in infants and with severe radiculomyeloencephalitic forms.