Predictive models for and infection in pathologically or serologically proved eosinophilic meningitis.

OBJECTIVE

The two most common causes of eosinophilic meningitis (EOM) are the parasites: and . This study aimed to evaluate whether clinical factors can predict either neuroangiostrongyliasis or gnathostomiasis in EOM patients.

MATERIALS AND METHODS

We included reports of patients with eosinophils in the CSF and either serological or pathological diagnosis of neuroangiostrongyliasis or gnathostomiasis published in 2014 or earlier and available on PubMed. Predictive clinical models were generated for neuroangiostrongyliasis and gnathostomiasis.

RESULTS

In total, 155 patients were included in the study, 24 in the gnathostomiasis group and 131 in the neuroangiostrongyliasis group. According to the separate models, factors associated with neuroangiostrongyliais were gender of male, snail exposure, and headache, and independent factors for gnathostomiasis were weakness (adjusted odds ratio 50.8) and radicular pain (adjusted odds ratio 35.3). The combined model identified two independent factors for neuroangiostrongyliasis: weakness and radicular pain. The laboratory models revealed that xanthochromic CSF perfectly predicted both neuroangiostrongyliasis and gnathostomiasis. Two other predictive factors were blood eosinophilia and CSF eosinophils, which positively predicted gnathostomiasis (adjusted odds ratios of 1.13 and 1.08, respectively).

CONCLUSION

Clinical factors may be predictive of neuroangiostrongyliasis and gnathostomiasis in EOM.