Comparison of Prednisolone Plus Albendazole with Prednisolone Alone for Treatment of Patients with Eosinophilic Meningitis

Abstract

Corticosteroid and the combination of corticosteroid and antihelminthic drug are safe and beneficial in relieving headaches in patients with eosinophilic meningitis. However, clinical trials comparing the efficacies of these regimens have never been reported. We conducted a prospective, open, randomized, controlled study to compare the efficacy of the combination of prednisolone plus albendazole and prednisolone alone for the treatment of eosinophilic meningitis. Our study had 53 patients in the combined treatment group and 51 patients in the prednisolone alone group. There were no significant differences between the two groups with regard to the number of patients who still had headaches after 14 days (0 versus 1, respectively; P = 0.49) and the median length of time until complete disappearance of headache (3 versus 3 days, respectively; P = 0.32. Prednisolone plus albendazole is no better than prednisolone alone for treatment of patients with eosinophilic meningitis.

Encephalitis Caused by Angiostrongylus cantonensis after Eating Raw Frogs Mixed with Wine as a Health Supplement

“…Chotmongkol et al (24) found that a 2-week course of prednisolone helped relieve the headache, shortened the median time until resolution of headache, and reduced the need for repeated lumbar puncture. They did not find a better treatment effect when combination therapy with prednisolone and albendazole was compared to prednisolone alone (25). We treated the present patient with a 2-week duration of prednisolone and the outcome was good.…”

Eosinophilic Meningitis Attributable to Angiostrongylus cantonensis Infection in Hawaii: Clinical Characteristics and Potential Exposures

“…[18][19][20] Treatment is primarily supportive; systemic corticosteroids may decrease symptom duration, but the use of antihelminthic therapy is controversial. 21,22 We previously reported a laboratory-and hospital-based investigation in Hawaii that included case data from January 2001 to February 2005. 23 In that study, we found a cluster of angiostrongyliasis cases that occurred on the island of Hawaii from November 2004 to February 2005.…”

First Evidence of Angiostrongyliasis Caused by Angiostrongylus cantonensis in Guadeloupe, Lesser Antilles

“…2,36 However, these drugs are widely used in some countries as they have been shown to relieve symptoms and reduce the extent of the disease in some patients. 31 Our collection and identification of A. cantonensisinfected snails reflected a high prevalence of the parasite in the region. Nearly three decades back, the only reported environmental investigation in Guadeloupe was done for A. costaricensis in rats (R. rattus and in R. norvegicus), which showed a total prevalence of 7.5% in the region.…”

“…Corticosteroid therapy was aimed at improving neurologic symptoms by limiting cranial inflammation. 30,31 Cerebral MRI and hematological investigations did not yield any information about the cause of disease. Typical laboratory findings of A. cantonensis can include peripheral hypereosinophilia, increased CSF pressure, increased CSF protein, and a normal or decreased CSF glucose.…”