A bstract Eosinophilic meningoencephalitis is an uncommon cause of pediatric central nervous system infection, most frequently caused by Angiostrongylus cantonensis . Early diagnosis is challenging because initial symptoms are nonspecific, and characteristic cerebrospinal fluid (CSF) abnormalities may be delayed. Here, we report a 14-month-old boy from a coastal region presenting with fever, lethargy, and isolated right abducens nerve palsy. Magnetic resonance imaging demonstrated leptomeningeal inflammation with focal parenchymal involvement and diffuse cerebral edema. CSF examination revealed marked eosinophilic pleocytosis, and polymerase chain reaction confirmed A. cantonensis . Early initiation of corticosteroids and albendazole resulted in rapid and complete neurological recovery. This report highlights the importance of considering eosinophilic meningoencephalitis in young children presenting with fever and focal neurological deficits. Early molecular diagnosis enables targeted therapy and avoids unnecessary antimicrobial exposure.
Krishnan et al. (2026) studied this question.