Staphylococcus warneri meningitis in a patient with Strongyloides stercoralis hyperinfection and lymphoma: first report of a case.
A case of meningitis due to Staphylococcus warneri in a patient with a hyperinfection with Strongyloides stercoralis possibly associated with rituximab treatment for mantel cell lymphoma is reported for the first time in the literature. The patient was a 59-year-old woman, with a 3-year history of an apparently well controlled lymphoma after treatment with chemotherapy-immunotherapy and then immunotherapy alone, and diagnosis of strongyloidiasis. Meningitis was diagnosed by cerebrospinal fluid culture and tested with an automated plate system. The patient was successfully treated with vancomycin; although fever and productive cough persisted. Severe gastrointestinal symptoms and pneumonia developed three weeks later. Hyperinfection syndrome by S. stercoralis was diagnosed, with abundant larvae in feces and expectoration.
Incani
Renzo Nino
RN
Departamento de Parasitología, Facultad de Ciencias de la Salud, Universidad de Carabobo, Valencia 2001, Venezuela. rincani@uc.edu.ve
Hernández
Marcos
M
Cortez
Jackeline
J
González
María Elena
ME
Salazar
Yaimir Dorel
YD
D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000150:complications* / Q000188:drug therapy; D016920:Meningitis, Bacterial / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D008875:Middle Aged; D000069283:Rituximab; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D017171:Strongyloides stercoralis / Q000302:isolation & purification*; D013322:Strongyloidiasis / Q000150:complications* / Q000175:diagnosis; D015163:Superinfection / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab