Correct!
2. Lumbar puncture

Artesunic acid is a medication obtained from the CDC for malaria. Malaria has not been reported in Fiji. Fluconazole is an anti-fungal and might be indicated should she prove to have coccidioidomycosis.  However, at this time there is no evidence of coccoides infection. Bronchoscopy and needle biopsy might be indicated but our overriding concern was her neurological problem and for that reason a lumbar puncture was performed. It showed a white blood cell count of 553 cells with 73% eosinophils. Glucose level is CSF was 33 mg/dl. Protein level was 144 mg/dl. Gram stain was negative.

A diagnosis of eosinophilic meningitis was made.

Which of the following are causes of eosinophilic meningitis?

  1. Angiostrongylus cantonensis
  2. Coccidioides immitis
  3. Hodgkin’s disease
  4. Ciprofloxacin
  5. All of the above


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