Chiu Hsien-Hsueh, Lai Shung-Lon
Department of Chinese Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Acta Neurol Taiwan. 2005 Mar;14(1):24-7.
A middle-aged aboriginal man with a history of alcoholism and gastrectomy was diagnosed as having bacterial meningoencephalitis based on the typical clinical manifestations, laboratory findings, and treatment responses. During the recovery stage, he developed consciousness disturbance, seizures, severe diarrhea, and respiratory failure that led us to search for other possibility of the diagnosis. The eosinophilia and repeated stool examinations helped us to make the diagnosis of disseminated strongyloidiasis. In this patient the initial bacterial meningitis was followed by S. stercoralis hyperinfection. Despite treatment with strong antimicrobial agents, the patient died. This case could serve as a reminder to physicians to be alert for strongyloidiasis superimposed on bacterial meningitis.
一名有酗酒和胃切除术病史的中年原住民男性，根据典型的临床表现、实验室检查结果及治疗反应，被诊断为细菌性脑膜脑炎。在恢复阶段，他出现意识障碍、癫痫发作、严重腹泻及呼吸衰竭，这促使我们探寻其他可能的诊断。嗜酸性粒细胞增多及多次粪便检查帮助我们确诊为播散性类圆线虫病。该患者最初为细菌性脑膜炎，随后发生了粪类圆线虫高度感染。尽管使用了强效抗菌药物治疗，患者仍死亡。该病例提醒医生要警惕细菌性脑膜炎合并类圆线虫病。
