Outcome of Eosinophilic meningitis in Mukdahan hospital

Abstract

Objective : 1. To study epidemiology, clinical characteristics, treatment outcome and mortality rate of eosinophilic meningitis in Mukdahan Hospital 2. To study the relationship between eosinophil in cerebrospinal fluid with Length of stay in patients eosinophilic meningitis

Materials and methods : This study was a retrospective descriptive study. The patient aged above 15 years old who were admitted in the Mukdahan Hospital with the diagnosis of eosinophilic meningitis between 2017 and 2020 . The medical records were reviewed. The patient characteristics, clinical features, complete blood count focusing on eosinophilia, cerebrospinal fluid study, the computed tomography of the brain, treatment with antiparasitic agents and the supportive treatment with analgesic drugs and corticosteroid, and clinical outcome were collected. The data were analyzed by the mean standard deviation (SD) or median and the discrete data were analyzed by percentage.

Results : Based on data analysis of 71 Eosinophilic meningitis patients, 74.60% were male, mean age 22.10 years, farming occupation 47.90%, most of them had no congenital disease, 84.50% were in the Muang district. Most people eat raw food such as shellfish, fish, pork, beef, and shrimp, accounting for 26.76%. The common symptoms were 97.18 % headache and 60.60% nausea and vomiting. Most patients had no symptoms (45.56%) however the most common presentation was neck stiffness (31.65%). Forty- two of patient had eosinophil more than 10 % in complete blood count. Treatment using analgesic drugs was Tramadol, 53.52%. Steroids injection of Dexamethasone 16 mg/day, followed by taking Prednisolone 1 MKD and antiparasitic, Albendazole 800 mg/day for 2 weeks. The treatment showed a 100% improvement in symptoms and no mortality. The average length of hospital stay was 3.71 days. Eosinophils in cerebrospinal fluid no significant statistical relationship to length of stay in eosinophilic meningitis. There was no significant relationship between numbers of eosinophils in CSF of patients with eosinophilia meningitis and length of hospital stay.

Conclusion : Most of them eosinophilic meningitis main presenting symptoms were headache and history of eat raw food. Treatment by steroid, analgesic and albendazole 800mg/day for 2 weeks showed improvement of symptoms. From this study, there was no significant relationship between numbers of eosinophils in CSF of eosinophilic meningitis and length of hospital stay.