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Five cases of recurrent meningitis associated with chronic strongyloidiasis

Teppei Shimasaki1, Heath Chung2, Soichi Shiiki2

  • 1Department 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.

The American Journal of Tropical Medicine and Hygiene
|December 31, 2014
PubMed

Insights

Chronic strongyloidiasis can lead to recurrent meningitis, especially with human T-lymphotropic virus type 1 (HTLV-1) infection. Ivermectin may be more effective than thiabendazol for treating this rare but deadly complication.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Parasitology

Background:

  • Chronic strongyloidiasis is a parasitic infection that can lead to serious complications.
  • Meningitis secondary to strongyloidiasis is rare but has a high mortality rate.
  • Recurrent meningitis necessitates effective treatment of the underlying parasitic infection.

Purpose of the Study:

  • To report cases of recurrent meningitis associated with chronic strongyloidiasis and human T-lymphotropic virus type 1 (HTLV-1) infection.
  • To compare the efficacy of ivermectin and thiabendazol in treating strongyloidiasis-related meningitis.

Main Methods:

  • Case series reporting five patients with recurrent meningitis.
  • Review of clinical symptoms, causative organisms, and treatment outcomes.
  • Comparison of treatment responses to thiabendazol and ivermectin.

Main Results:

  • Five cases of recurrent meningitis linked to chronic strongyloidiasis and HTLV-1 infection were identified.
  • Common bacterial pathogens included Escherichia coli, Streptococcus bovis, and Klebsiella pneumonia.
  • Four patients experienced multiple recurrences despite thiabendazol treatment; ivermectin showed better eradication potential.

Conclusions:

  • Chronic strongyloidiasis, particularly in HTLV-1 infected individuals, poses a risk for recurrent meningitis.
  • Ivermectin appears to be a more effective treatment for eradicating strongyloidiasis than thiabendazol.
  • Prompt diagnosis and effective antiparasitic treatment are crucial for managing this severe complication.

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