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Updated: Feb 2, 2026

Isolating Central Nervous System Tissues and Associated Meninges for the Downstream Analysis of Immune cells
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Isolating Central Nervous System Tissues and Associated Meninges for the Downstream Analysis of Immune cells

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Strongyloidiasis and Culture-Negative Suppurative Meningitis, Japan, 1993-2015

Mitsuru Mukaigawara, Izumi Nakayama, Koichiro Gibo

    Emerging Infectious Diseases
    |November 21, 2018
    PubMed

    Insights

    Strongyloidiasis is a potential cause of rare, atypical meningitis in adults. This parasitic infection was found in over half of patients with unusual suppurative meningitis, highlighting its importance.

    Area of Science:

    • Infectious Diseases
    • Parasitology
    • Neurology

    Background:

    • Community-acquired Enterobacteriaceae infection and culture-negative meningitis are uncommon in adults.
    • Atypical suppurative meningitis presents diagnostic challenges.

    Observation:

    • A retrospective study in Okinawa, Japan (1993-2015) identified 37 adult patients with atypical suppurative meningitis.
    • Strongyloidiasis was diagnosed in 54.5% of these patients.

    Findings:

    • Among patients with strongyloidiasis, 9.1% experienced hyperinfection and 3.0% had disseminated disease.
    • Enterobacteriaceae infection and culture-negative meningitis subtypes were noted.

    Implications:

    • Strongyloidiasis should be considered a significant underlying cause of atypical suppurative meningitis.
    • Increased awareness of strongyloidiasis is crucial for diagnosing and managing these rare meningitis cases.
    Keywords:
    EnterobacteriaceaeHTLV-1JapanOkinawaStrongyloidiasisbacteriaculture-negative suppurative meningitismeningitis/encephalitisparasites

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