A Case of Steroid-induced Hyperinfective Strongyloidiasis with Bacterial Meningitis.
10.4166/kjg.2012.60.5.330
- Author:
Joo Yun CHO
1
;
Joong Goo KWON
;
Kyung Ho HA
;
Jae Young OH
;
Myung In JIN
;
Seong Wook HEO
;
Geun Ho LEE
;
Chang Ho CHO
Author Information
1. Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. kwonjg@cu.ac.kr
- Publication Type:Case Reports ; English Abstract
- Keywords:
Strongyloides stercoralis;
Meningitis;
Steroids
- MeSH:
Adrenal Insufficiency/drug therapy;
Aged;
Animals;
Bronchoalveolar Lavage Fluid/parasitology;
Endoscopy, Gastrointestinal;
Enterococcus faecium/isolation & purification;
Female;
Humans;
Immunocompromised Host;
Intestinal Mucosa/pathology;
Larva/physiology;
Magnetic Resonance Imaging;
Meningitis, Bacterial/complications/*diagnosis/microbiology;
Steroids/adverse effects/therapeutic use;
Strongyloides stercoralis/growth & development/isolation & purification;
Strongyloidiasis/complications/*diagnosis/parasitology
- From:The Korean Journal of Gastroenterology
2012;60(5):330-334
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Strongyloides stercoralis is a soil transmitted intestinal nematode that is endemic in the tropical and subtropical regions. In most individuals who are infected, chronic, usually asymptomatic, gastrointestinal infection persists. But, in immunocompromized hosts or in patients receiving immunosuppressive therapy, autoinfection of S. stercoralis may result in the dissemination of larvae, leading to fatal hyperinfection and increased rate of complications. We report a case of hyperinfective strongyloidiasis with bacterial meningitis in a patient receiving steroid therapy. Strongyloidiasis was diagnosed by the presence of filariform larvae of S. stercoralis in the bronchoalveolar lavage cytology and upper gastrointestinal endoscopic biopsy specimen. Her clinical symptoms had progressively aggravated and developed bacterial meningitis during treatment. She died despite aggressive antibiotic and antihelminthic therapy.
