article = {JCMCR-2020-1-104}
title = {Two Cases of Meningitis Associated with Gram Negative Bacteremiae and Strongyloidiasis}
journal = {Journal of Clinical and Medical Case Reports}
year = {2020}
issn = {2733-2268}
doi = {http://dx.doi.org/10.31487/j.JCMCR.2020.01.04}
url = {https://www.sciencerepository.org/two-cases-of-meningitis-associated_JCMCR-2020-1-104 
author = {A. Belkacem ,J. Breuil ,Kevin DIALLO,P. Caraux-Paz ,}
keywords = {Meningitis, strongyloides stercoralis, bacteremiae, HTLV-1}
abstract ={Background: Strongyloidiasis is a neglected tropical disease and is widely distributed. HTLV-1 coinfection is frequent, and this disease increases the risk of hyper infestation. Disseminated strongyloidiasis
often causes severe enterobacteria infection.
Case Presentation: We report the cases of two patients presenting with meningial syndrome. The
meningitis was associated with a Gram negative bacteremiae. The investigations performed proved an
infection or a previous contact with Strongyloides stercoralis. The infectious outcome was favorable after
antibiotic treatment and antiparasitic treatment but one of them was also co-infected with HTLV-1 and died
after a lymphoma occurred.
Discussion: S. stercoralis infects the intestinal mucosa, and chronic infection of this pathogen induces
inflammation of the intestinal mucosa. Enteric bacteria can gain systemic access and be responsible of organ
involvement, including Central Nervous System. HTLV-1 infection increases the prevalence of
strongyloidiasis, the rate of treatment failure, and the risk of hyperinfestation.
Conclusions: Strongyloidiasis should not be underdiagnosed, as a specific treatment with antiparasitic
drugs is available. We should perform direct microscopy of the stool to detect S. stercoralis in patients who
develop severe enterobacterial infection when patients are from an endemic area.}