title: [A case of steroid-induced hyperinfective strongyloidiasis with bacterial meningitis].
abstract: Strongyloides stercoralis is a soil transmitted intestinal nematode that is endemic in the tropical and subtropical regions. In most individuals who are infected, chronic, usually asymptomatic, gastrointestinal infection persists. But, in immunocompromized hosts or in patients receiving immunosuppressive therapy, autoinfection of S. stercoralis may result in the dissemination of larvae, leading to fatal hyperinfection and increased rate of complications. We report a case of hyperinfective strongyloidiasis with bacterial meningitis in a patient receiving steroid therapy. Strongyloidiasis was diagnosed by the presence of filariform larvae of S. stercoralis in the bronchoalveolar lavage cytology and upper gastrointestinal endoscopic biopsy specimen. Her clinical symptoms had progressively aggravated and developed bacterial meningitis during treatment. She died despite aggressive antibiotic and antihelminthic therapy.
authors.affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Joo Yun
authors.initials: JY
authors.lastname: Cho
authors.forename: Joong Goo
authors.initials: JG
authors.lastname: Kwon
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Ha
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Oh
authors.forename: Myung In
authors.initials: MI
authors.lastname: Jin
authors.forename: Seong Wook
authors.initials: SW
authors.lastname: Heo
authors.forename: Geun Ho
authors.initials: GH
authors.lastname: Lee
authors.forename: Chang Ho
authors.initials: CH
authors.lastname: Cho
mesh_terms: D000309:Adrenal Insufficiency / Q000188:drug therapy; D000368:Aged; D000818:Animals; D001992:Bronchoalveolar Lavage Fluid / Q000469:parasitology; D016099:Endoscopy, Gastrointestinal; D016984:Enterococcus faecium / Q000302:isolation & purification; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007413:Intestinal Mucosa / Q000473:pathology; D007814:Larva / Q000502:physiology; D008279:Magnetic Resonance Imaging; D016920:Meningitis, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use; D017171:Strongyloides stercoralis / Q000254:growth & development / Q000302:isolation & purification; D013322:Strongyloidiasis / Q000150:complications / Q000175:diagnosis* / Q000469:parasitology
chemical_list: D013256:Steroids