Bacterial complications of strongyloidiasis: Streptococcus bovis meningitis.
We report the case of a 64-year-old veteran who had Streptococcus bovis meningitis as a result of a long latent Strongyloides infection that became acute when he was treated with prednisone. We reviewed 38 reported cases of serious bacterial infections associated with strongyloidiasis. Patients most frequently had nonspecific gastrointestinal symptoms. Of these 38 patients, 21 (55%) had meningitis, and 28 (73%) had bacteremia that was polymicrobial in 3 cases (8%). Other sites of infection included lung, bone marrow, ascites, mitral valve, and lymph node. Most infections were due to enteric gram-negative bacteria. There is one previously reported case of S bovis meningitis. Thirty-four of the patients (89%) were immunosuppressed; 21 of these (55%) were taking pharmacologic doses of adrenal corticosteroids. Thirty-three of the 38 (87%) patients died. Patients with enteric bacterial infection without an obvious cause should be tested for the presence of strongyloidiasis.
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Hunter Holmes McGuire Department of Veterans Affairs Medical Center, Department of Medicine, Virginia Commonwealth University, Medical College of Virginia, Richmond, USA.
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D000818:Animals; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D016470:Bacteremia / Q000209:etiology*; D013293:Enterococcus faecalis; D013700:Giant Cell Arteritis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016908:Gram-Positive Bacterial Infections / Q000209:etiology*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D016920:Meningitis, Bacterial / Q000209:etiology*; D008875:Middle Aged; D011241:Prednisone / Q000009:adverse effects*; D013290:Streptococcal Infections / Q000209:etiology*; D016985:Streptococcus bovis; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology
D000893:Anti-Inflammatory Agents; D011241:Prednisone