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Strongyloides hyperinfection syndrome following resection of meningioma
Clifford Leigh Shelton1, Timothy Smith, Konstantina Karabatsou
1Macclesfield District General Hospital, Macclesfield, UK. cliff.shelton@nhs.net
Abstract:
In this report, we present the case of a patient who developed the strongyloides hyperinfection syndrome 3 weeks after an uneventful resection of a sphenoid wing meningioma. She originally presented with symptoms of raised intracranial pressure and was given dexamethasone before surgery. The pathology, diagnosis and management of Strongyloides stercoralis are reviewed.
Insights
A patient developed Strongyloides hyperinfection syndrome weeks after brain surgery for a sphenoid wing meningioma. This case highlights the importance of considering parasitic infections post-immunosuppression.
Area of Science:
- Neuro-oncology
- Infectious Diseases
- Immunology
Background:
- Sphenoid wing meningiomas can cause symptoms of raised intracranial pressure.
- Corticosteroid therapy, such as dexamethasone, is often used to manage such symptoms.
- Surgical resection is a common treatment for meningiomas.
Observation:
- A patient developed severe Strongyloides hyperinfection syndrome three weeks post-operatively.
- The patient had received dexamethasone prior to surgery for a sphenoid wing meningioma.
- The syndrome occurred despite an otherwise uneventful surgical procedure.
Findings:
- Strongyloides hyperinfection syndrome is a potentially fatal complication in immunocompromised individuals.
- The timing suggests a link between corticosteroid use, surgery, and parasite reactivation or autoinfection.
- Early diagnosis and treatment of Strongyloides stercoralis are crucial.
Implications:
- Clinicians should maintain a high index of suspicion for Strongyloides in patients with relevant exposure history, especially after immunosuppressive therapy.
- This case underscores the need for careful pre-operative screening and post-operative monitoring for parasitic infections.
- Understanding the interplay between meningioma treatment and opportunistic infections is vital for patient management.
