Template:ID-Parasitic meningitis

• Meningitis, parasitic

• 1. Protozoal meningitis

• 1.1 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

• 1.2 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

• 2. Helminthic meningitis

• 2.1 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

• 2.2 Baylisascaris procyonis

• Preferred regimen: Albendazole 25–50 mg/kg PO qd or 400 mg PO bid for 10 days AND Dexamethasone 10–20 mg PO qd for 10 days
• Alternative regimen: Thiabendazole 50 mg/kg/day PO bid for 10 days AND Dexamethasone 10–20 mg PO qd for 10 days

• 2.3 Gnathostoma spinigerum

• Preferred regimen: Albendazole 400 mg PO bid for 3 weeks AND Dexamethasone 10–20 mg PO qd for 3 weeks
• Alternative regimen: Ivermectin 0.2 mg/kg PO qd for 2 days AND Dexamethasone 10–20 mg PO qd for 3 weeks