title: Meningitis associated with strongyloidiasis in an area endemic for strongyloidiasis and human T-lymphotropic virus-1: a single-center experience in Japan between 1990 and 2010.
abstract: Meningitis caused by enteric flora is a known complication of strongyloidiasis, and human T-lymphotropic virus-1 (HTLV-1) predisposes individuals to severe strongyloidiasis. We reviewed the clinical features of bacterial meningitis associated with strongyloidiasis seen at a single center in subtropical Japan, in an area endemic for both strongyloidiasis and HTLV-1. We found 33 episodes in 21 patients between 1990 and 2010. The results were remarkable for the high incidence of meningitis due to Gram-positive cocci (27.3 %), especially Streptococcus bovis, and culture-negative cases (42.4 %). Given the high incidence of Gram-positive meningitis, a modified approach to corticosteroid use would be advisable in areas where strongyloidiasis is endemic, due to the potentially adverse consequences of glucocorticoid therapy.
authors.affiliation: Department of Medicine, Okinawa Chubu Hospital, Okinawa, Japan, pqrstbb@yahoo.co.jp.
authors.forename: Y
authors.initials: Y
authors.lastname: Sasaki
authors.forename: T
authors.initials: T
authors.lastname: Taniguchi
authors.forename: M
authors.initials: M
authors.lastname: Kinjo
authors.forename: R L
authors.initials: RL
authors.lastname: McGill
authors.forename: A T
authors.initials: AT
authors.lastname: McGill
authors.forename: S
authors.initials: S
authors.lastname: Tsuha
authors.forename: S
authors.initials: S
authors.lastname: Shiiki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060085:Coinfection / Q000382:microbiology / Q000469:parasitology / Q000821:virology; D005260:Female; D015490:HTLV-I Infections / Q000382:microbiology* / Q000469:parasitology*; D006801:Humans; D007564:Japan; D008297:Male; D016920:Meningitis, Bacterial / Q000382:microbiology / Q000469:parasitology* / Q000821:virology; D008875:Middle Aged; D012189:Retrospective Studies; D016985:Streptococcus bovis / Q000302:isolation & purification; D013322:Strongyloidiasis / Q000382:microbiology* / Q000821:virology