title: Severe strongyloidiasis complicated by meningitis and hydrocephalus in an HTLV-1 carrier with increased proviral load.
abstract: We report a 47-year-old Japanese man who was a human T-cell leukemia virus type 1 (HTLV-1) carrier with strongyloidiasis, and who was born in an area endemic for both Strongyloides stercoralis ( S. stercoralis) and HTLV-1. He presented with edema of both legs. Laboratory examination on admission revealed hypoalbuminemia, and S. stercoralis rhabditiform larvae were found by stool microscopy. Purulent meningitis, which was suspected to be due to disseminated strongyloidiasis, developed during the first and second treatment for S. stercoralis infection. After the meningitis was alleviated, hydrocephalus with gait disturbance developed, and these features were attenuated by a ventriculo-peritoneal shunt. Impaired immunity and increased HTLV-1 proviral load, with an increased titer of HTLV-1 antibody, were observed in this patient. These results suggest that HTLV-1 proviral load and/or antibody titer of HTLV-1 can be used for the identification of carriers who are at increased risk of developing severe strongyloidiasis among those patients who are infected with both S. stercoralis and HTLV-1.
authors.affiliation: Department of Medical Zoology, Saitama Medical School, 350-0495 Saitama, Morohongo, Moroyama, Japan. satoma@saitama-med.ac.jp
authors.forename: Masao
authors.initials: M
authors.lastname: Satoh
authors.forename: Atsushi
authors.initials: A
authors.lastname: Futami
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Takahira
authors.forename: Makoto
authors.initials: M
authors.lastname: Kodaira
authors.forename: Tokutaro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Ken
authors.initials: K
authors.lastname: Kuriki
authors.forename: Eitaro
authors.initials: E
authors.lastname: Hori
mesh_terms: D000818:Animals; D002353:Carrier State / Q000821:virology*; D015481:HTLV-I Antibodies / Q000097:blood; D015490:HTLV-I Infections / Q000150:complications*; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification; D006801:Humans; D006849:Hydrocephalus / Q000150:complications*; D008297:Male; D020814:Meningitis, Escherichia coli / Q000150:complications* / Q000382:microbiology; D008875:Middle Aged; D011533:Proviruses / Q000502:physiology*; D017171:Strongyloides stercoralis / Q000302:isolation & purification; D013322:Strongyloidiasis / Q000150:complications*; D019562:Viral Load
chemical_list: D015481:HTLV-I Antibodies