[Meningitis caused by Enterococcus faecalis during disseminated anguilluliasis].
BACKGROUND
Disseminated anguilluliasis is a serious disease requiring early diagnosis and treatment. The occurrence of bacterial complications, especially meningeal, is generally due to Gram-negative bacteria from the gastrointestinal tract.


METHODS
A 52-year-old man from Guadeloupe, treated for T-lymphoma during the previous year by polychemotherapy, was hospitalized for meningitis. Culture of the cerebrospinal fluid and the bronchoalveolar lavage both showed Enterococcus faecalis. Strongyloides stercoralis were also found in the stool and bronchoalveolar lavage. Outcome under treatment was favorable.


CONCLUSIONS
This case reminds us of the usefulness of presumptive routine ivermectin treatment for all patients exposed to any immunosuppression treatment and ever having lived in a tropical area and thus possibly infected by chronic but silent anguilluliasis, even in the absence of parasitological certainty.
Zahar
Jean-Ralph
JR
Service de réanimation polyvalente, Institut Gustave Roussy, Villejuif. jean-ralph.zahar@nck.ap-hop-paris.fr
Tankovic
Jacques
J
Catherinot
Emilie
E
Meshaka
Patrick
P
Nitenberg
Gérard
G
D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000977:Antiparasitic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid; D002555:Cerebrospinal Fluid / Q000382:microbiology; D004359:Drug Therapy, Combination; D013293:Enterococcus faecalis / Q000302:isolation & purification; D005243:Feces / Q000469:parasitology; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D017171:Strongyloides stercoralis / Q000302:isolation & purification; D013322:Strongyloidiasis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000977:Antiparasitic Agents; D005839:Gentamicins; D007559:Ivermectin; D000658:Amoxicillin