Fasciola hepatic rarely can cause a disseminated disease, sometimes involving the central nervous system.
Clinical features:
(1) eosinophilic meningitis (absolute eosinophil count in CSF > 10 per µL, or > 10% of differential) )
(2) variable subarachnoid hemorrhage
(3) evidence of Fascioliasis in other organs
(4) epidemiologic risk factors for Fascioliasis
(5) laboratory evidence of Fasciola hepatica (positive stool exam, serology, PCR on CSF)
(6) exclusion of other conditions
Other parasites associated with meningitis:
(1) Angiostrongylus (Parastrongylus) cantonensis
(2) Gnathostomaspinigerum
(3) cysticercosis (Taenia solium)
(4) Baylisascarisprocyonis (raccoon roundworm)
(5) toxoplasmosis
