Angiostrongylus cantonensis is a zoonotic nematode mostly involved in eosinophilic meningitis and ocular manifestations. Primary described in Southeast Asia and Pacific Islands, it had spread to America continent, including Caribbean.

We report a case series of four patients with eosinophilic meningitis in Martinique. The first patient was a ten-months-old girl presenting with fever and clinical deterioration, followed with unilateral cranial nerves VI palsy. The second one was a ten-months-old boy, also presenting with fever and clinical deterioration but associated with simple partial seizure. The following was a 37-years-old man suffering from subacute afebrile headaches associated with nausea and vomiting, followed by radiculalgia and unilateral cranial nerves VI palsy. The last patient was a 63-years-old man, presenting with Glasgow Coma Scale score of 9 without fever at the time of admission. Initial clinical symptoms were not well defined due to the patient intellectual disabilities. Human angiostrongylosis was suspected in front of eosinophilic meningitis, with or without blood eosinophilia, and risk factors for contamination. Diagnosis was confirmed with serological tests. All patients but one adult received antiparasitic therapies. Clinical outcome was good for all of them.

Presence of definitive rodent hosts, and recent importation of intermediate snail hosts such as Achatina fulica, leads to the spread of A. cantonensis in Martinique, as others Carribean islands. This is an emergent public health problem, due to the difficulty to eradicate this parasite from the environment. However, it should be possible to avoid infections by a better understanding of the population on ways of contamination.