Template:ID-Parasitic meningitis

• Meningitis, parasitic

• Protozoal meningitis

• Naegleria fowleri (primary amebic meningoencephalitis)

• Preferred regimen: (Amphotericin B 1.5 mg/kg/day IV q12h for 3 days, followed by Amphotericin B 1 mg/kg/day IV q24h for 11 days) AND (Amphotericin B 1.5 mg/kg/day intrathecal q24h for 2 days, followed by Amphotericin B 1 mg/kg/day intrathecal qod for 8 days) AND Azithromycin 10 mg/kg/day IV/PO q24h for 28 days AND Fluconazole 10 mg/kg/day IV/PO q24h for 28 days AND Rifampin 10 mg/kg/day IV/PO q24h for 28 days AND Miltefosine 50 mg PO bid–tid for 28 days AND Dexamethasone 0.15 mg/kg IV q6h for 4 days

• Toxoplasma gondii

• Preferred regimen: Sulfadiazine 4–6 g/day q6h AND Pyrimethamine 25–100 mg/day qd
• Alternative regimen (1): Pyrimethamine 25–100 mg/day qd AND Clindamycin 2400–4800 mg/day IV q6h
• Alternative regimen (2): Pyrimethamine 25–100 mg/day qd AND (Azithromycin 1200–1500 mg/day IV q24h OR Atovaquone 750 mg IV q6h OR Dapsone 100 mg PO q24h)
• Alternative regimen (3): TMP-SMZ 10–20 mg/kg/day q6–12h

• Helminthic meningitis

• Angiostrongylus cantonensis

• Preferred regimen: Albendazole 15–20 mg/kg/day PO qd–bid for 10–20 days AND Dexamethasone 10–20 mg PO qd for 10–20 days
• Alternative regimen: Mebendazole 100 mg PO bid for 10–20 days AND Dexamethasone 10–20 mg PO qd for 10–20 days

Adapted from Lancet Infect Dis. 2008;8(10):621-30. and Clin Infect Dis. 2009;48(3):322-7.[12][13]

• Baylisascaris procyonis

Preferred Regimen ▸ Albendazole 25–50 mg/kg PO qd or 400 mg PO bid for 10 days PLUS ▸ Dexamethasone 10–20 mg PO qd for 10 days Alternative Regimen ▸ Thiabendazole 50 mg/kg/day PO bid for 10 days PLUS ▸ Dexamethasone 10–20 mg PO qd for 10 days Adapted from Clin Microbiol Rev. 2005;18(4):703-18. and Clin Infect Dis. 2004;15;39(10):1484-92.[14][15]

• Gnathostoma spinigerum

Preferred Regimen ▸ Albendazole 400 mg PO bid for 3 weeks PLUS ▸ Dexamethasone 10–20 mg PO qd for 3 weeks Alternative Regimen ▸ Ivermectin 0.2 mg/kg PO qd for 2 days PLUS ▸ Dexamethasone 10–20 mg PO qd for 3 weeks Adapted from Clin Microbiol Rev. 2009;22(3):484-92. and Clin Infect Dis. 2009;48(3):322-7.[16][13]