Objective: To describe clinical features and outcome in a cohort of children with eosinophilicmeningitis, a rare atypical form of meningitis.

Study design: We conducted a retrospective study of children admitted in our institution withcharacteristic signs and symptoms suggestive of eosinophilic meningitis during the period January2008 to March 2018.

Results: During this study, we had identified 13 children (eight boys and five girls) with EM. Meanage was 3.6 years, but 77% are less than 2years. Geographically 11 children were residing at coastalarea of Ernakulum district and 8 children gave history of exposure to snails. Mainsymptomatologies were fever, headache, irritability, lateral rectus palsy and early papilloedema.Other rare features are seizures and acute flaccid paralysis. All the children were symptomatic for 3to 35 days (Median duration of 2 weeks) before admission. All children had peripheral eosinophiliaranging from 15-54%. All the children showed CSF eosinophilic pleocytosis range from 18-80%eosinophils with a mean CSF white cell count 432 cells. CSF proteins were markedly raised (mean97 mg/dl). One patient had high CSF pressure. Neuroimaging was abnormal in 5 children amongthese only two showed leptomeningeal enhancement. All children were treated with albendazole,steroid and other supportive measures. All are recovered. All children peripheral smear showednormal eosinophilic count within 3-7days. Follow up period ranged from 2-8months and allchildren were asymptomatic at the last follow up.

Conclusion: We report one of the largest clinical series of children with eosinophilic meningitisfrom India. Treatment with albendazole and steroids have a favorable outcome.