title: Five cases of recurrent meningitis associated with chronic strongyloidiasis.
abstract: Although meningitis secondary to chronic strongyloidiasis is a rare complication, it is associated with a high mortality rate. Recurrent meningitis can occur if the underlying parasitic infection is left untreated. We report five cases of recurrent meningitis related to chronic strongyloidiasis that were associated with human T-lymphotropic virus type 1 (HTLV-1) infection. Common causative organisms are Escherichia coli, Streptococcus bovis, and Klebsiella pneumonia. One patient died during the second episode of meningitis. Three patients showed significant gastrointestinal and respiratory symptoms before developing headache and fever. In four cases, patients developed multiple recurrences even with the treatment of thiabendazol. Ivermectin seems to be a better agent compared with thiabendazol to achieve eradication of strongyloidiasis.
authors.affiliation: Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii; Department of Medicine, Okinawa Chubu Hospital, Okinawa, Japan shimasaki.t@gmail.com.
authors.forename: Teppei
authors.initials: T
authors.lastname: Shimasaki
authors.affiliation: Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii; Department of Medicine, Okinawa Chubu Hospital, Okinawa, Japan.
authors.forename: Heath
authors.initials: H
authors.lastname: Chung
authors.affiliation: Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii; Department of Medicine, Okinawa Chubu Hospital, Okinawa, Japan.
authors.forename: Soichi
authors.initials: S
authors.lastname: Shiiki
mesh_terms: D000328:Adult; D000368:Aged; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D015490:HTLV-I Infections / Q000150:complications; D015368:Human T-lymphotropic virus 1; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D016920:Meningitis, Bacterial / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies; D013322:Strongyloidiasis / Q000150:complications* / Q000188:drug therapy*; D013827:Thiabendazole / Q000008:administration & dosage / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D007559:Ivermectin; D013827:Thiabendazole