E. coli Meningitis Presenting in a Patient with Disseminated Strongyloides stercoralis
Introduction. Spontaneous Escherichia coli meningitis is an infrequent condition in adults and is associated with some predisposing factors, including severe Strongyloides stercoralis (SS) infections. Case Presentation. A 43-year-old Hispanic man, with history of travelling to the jungle regions of...
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| Format: | Article |
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Wiley
2013-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2013/424362 |
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| author | Juliana B. Gomez Yvan Maque Manuel A. Moquillaza William E. Anicama |
| author_facet | Juliana B. Gomez Yvan Maque Manuel A. Moquillaza William E. Anicama |
| author_sort | Juliana B. Gomez |
| collection | DOAJ |
| description | Introduction. Spontaneous Escherichia coli meningitis is an infrequent condition in adults and is associated with some predisposing factors, including severe Strongyloides stercoralis (SS) infections. Case Presentation. A 43-year-old Hispanic man, with history of travelling to the jungle regions of Peru and Brazil two decades ago, and who received prednisone due to Bell’s palsy for three weeks before admission, presented to the Emergency Department with diarrhea, fever, and hematochezia. A week after admission he developed drowsiness, meningeal signs, abdominal distension, and constipation. A cerebrospinal fluid culture showed extended spectrum β-lactamase producing E. coli. A colonoscopy was performed and showed pancolitis. Three days after the procedure the patient became unstable and developed peritoneal signs. He underwent a laparotomy, which ended up in a total colectomy and partial proctectomy due to toxic megacolon. Three days later the patient died in the intensive care unit due to septic shock. Autopsy was performed and microscopic examination revealed the presence of multiple Strongyloides larvae throughout the body. Conclusion. Strongyloides stercoralis infection should be excluded in adults with spontaneous E. coli meningitis, especially, if gastrointestinal symptoms and history of travelling to an endemic area are present. Even with a proper diagnosis and management, disseminated strongyloidiasis has a poor prognosis. |
| format | Article |
| id | doaj-art-963d1266df854db7a6eb0f9f13c89f19 |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-963d1266df854db7a6eb0f9f13c89f192025-02-03T05:53:58ZengWileyCase Reports in Infectious Diseases2090-66252090-66332013-01-01201310.1155/2013/424362424362E. coli Meningitis Presenting in a Patient with Disseminated Strongyloides stercoralisJuliana B. Gomez0Yvan Maque1Manuel A. Moquillaza2William E. Anicama3Department of Internal Medicine, Guillermo Almenara Irigoyen National Hospital, Lima, PeruGrupo de Investigacion en Inmunologia, Universidad Nacional de San Agustin, Arequipa, PeruDepartment of Neurology, Guillermo Almenara Irigoyen National Hospital, Lima, PeruDepartment of Pathology, Guillermo Almenara Irigoyen National Hospital, Lima, PeruIntroduction. Spontaneous Escherichia coli meningitis is an infrequent condition in adults and is associated with some predisposing factors, including severe Strongyloides stercoralis (SS) infections. Case Presentation. A 43-year-old Hispanic man, with history of travelling to the jungle regions of Peru and Brazil two decades ago, and who received prednisone due to Bell’s palsy for three weeks before admission, presented to the Emergency Department with diarrhea, fever, and hematochezia. A week after admission he developed drowsiness, meningeal signs, abdominal distension, and constipation. A cerebrospinal fluid culture showed extended spectrum β-lactamase producing E. coli. A colonoscopy was performed and showed pancolitis. Three days after the procedure the patient became unstable and developed peritoneal signs. He underwent a laparotomy, which ended up in a total colectomy and partial proctectomy due to toxic megacolon. Three days later the patient died in the intensive care unit due to septic shock. Autopsy was performed and microscopic examination revealed the presence of multiple Strongyloides larvae throughout the body. Conclusion. Strongyloides stercoralis infection should be excluded in adults with spontaneous E. coli meningitis, especially, if gastrointestinal symptoms and history of travelling to an endemic area are present. Even with a proper diagnosis and management, disseminated strongyloidiasis has a poor prognosis.http://dx.doi.org/10.1155/2013/424362 |
| spellingShingle | Juliana B. Gomez Yvan Maque Manuel A. Moquillaza William E. Anicama E. coli Meningitis Presenting in a Patient with Disseminated Strongyloides stercoralis Case Reports in Infectious Diseases |
| title | E. coli Meningitis Presenting in a Patient with Disseminated Strongyloides stercoralis |
| title_full | E. coli Meningitis Presenting in a Patient with Disseminated Strongyloides stercoralis |
| title_fullStr | E. coli Meningitis Presenting in a Patient with Disseminated Strongyloides stercoralis |
| title_full_unstemmed | E. coli Meningitis Presenting in a Patient with Disseminated Strongyloides stercoralis |
| title_short | E. coli Meningitis Presenting in a Patient with Disseminated Strongyloides stercoralis |
| title_sort | e coli meningitis presenting in a patient with disseminated strongyloides stercoralis |
| url | http://dx.doi.org/10.1155/2013/424362 |
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