Eosinophilic Meningitis After Bovine Graft Duraplasty:a Case Report and Literature Review

Abstract

Background Eosinophilic meningitis after bovine graft duraplastyis is extremely rare, and cerebrospinal fluid cytology is of great significance for the diagnosis of this disease.Conventional anti-infective treatment was ineffective in most patients, and symptoms were relieved after the use of steroids or removal of the artificial dura. Case presentation: We report the first case of eosinophilic meningitis after bovine graft duraplastyis in China.A 7-year-old girl underwent cerebellar tumor resection and duraplasty in our hospital, using bovine dura mater.After 13 days, she developed fever, poor mental state, and cervical resistance. The cerebrospinal fluid(CSF) examination showed increased white blood cells, low glucose, and high protein. The Cerebrospinal fluid cytology revealed an eosinophil-reactive type. Metagenomic next-generation sequencing of cerebrospinal fluid was negative and no tumor cells were found in CSF. Vancomycin and meropenem were ineffective in treatment, but symptoms disappeared after dexamethasone administration.Cerebrospinal fluid improved after immunotherapy.Symptoms did not recur after discontinuation of antibiotics. Conclusion Eosinophilic meningitis after bovine graft duraplastyis is extremely rare, and cerebrospinal fluid cytology is of great significance for the diagnosis of this disease.Conventional anti-infective treatment was ineffective in most patients, and symptoms were relieved after the use of steroids or removal of the artificial dura