Enterococcal meningitis due to strongyloidiasis with HTLV-1 carrier

A 40-year-old Japanese Brazilian admitted to our hospital because of headache and fever. He came to Japan 16 years ago and underwent treatment of strongyloidiasis 3 years ago. He showed neck stiffness. CRP was highly elevated, and anti-HTLV-1 antibody was positive. Examination of CSF demonstrated pl...

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Bibliographic Details
Published inRinshō shinkeigaku Vol. 46; no. 10; p. 715
Main Authors Sugiura, Akira, Fujimoto, Masaya, Saida, Yasuhiko
Format Journal Article
LanguageJapanese
Published Japan 01.10.2006
Subjects
Adult
Animals
Carrier State
Enterococcus faecalis
Gram-Positive Bacterial Infections - etiology
HTLV-I Infections - complications
Humans
Male
Meningitis, Bacterial - etiology
Strongyloides stercoralis
Strongyloidiasis - complications
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Summary:A 40-year-old Japanese Brazilian admitted to our hospital because of headache and fever. He came to Japan 16 years ago and underwent treatment of strongyloidiasis 3 years ago. He showed neck stiffness. CRP was highly elevated, and anti-HTLV-1 antibody was positive. Examination of CSF demonstrated pleocytosis, and neutrophils were dominant. Culture of CSF yielded Enterococcus faecalis, and we diagnosed his condition as enterococcal meningitis. Enterococcal meningitis was cured by administration of ampicillin and ceftriaxone. Enhanced abdominal CT scan was performed in order to detect the infectious focus which induced enterococcal meningitis. It showed wall thickening, wall enhancement and fluid collection in duodenum and upper jejunum. Strongyloides stercoralis was detected in stool and duodenal juice and mucosa. It turned out that strongyloidiasis had persisted. Strongyloidiasis was cured by administration of ivermectin. We supposed that enteric enterococcus invaded the blood by dissemination of Strongyloides stercoralis, and meningitis was induced by hematogenous infection.
ISSN:0009-918X