Domínguez Víctor Rodríguez, Pérez-López Carlos, Sánchez Catalina Vivancos, Contreras Cristina Utrilla, Guerrero Alberto Isla, Abenza Abildúa María José
Departments of1Neurosurgery and.
3Neuroradiology, Hospital Universitario la Paz, Madrid, Spain.
J Neurosurg Case Lessons. 2022 Jul 11;4(2):CASE21667. doi: 10.3171/CASE21667.
Strongyloidiasis is an underdiagnosed and preventable life-threatening disease caused by infection with the helminth . Chronic asymptomatic infection can be sustained for decades, and immunosuppression can lead to disseminated infection, with a mortality rate of 70%-100%. In the neurosurgical population, corticosteroids are the most consistent cause of hyperinfection.
The authors present the case of a 33-year-old woman of Paraguayan origin who was diagnosed with sphenoid planum meningioma and treated with a high dose of corticosteroids on the basis of the diagnosis. She underwent surgery, and pathological anatomy reflected grade I meningioma. After the surgery, she started with a history of dyspnea, productive cough, fever, and urticarial rash. Later, she presented with intestinal pseudo-obstruction and bacterial meningitis with hydrocephalus. Serology was positive for (enzyme-linked immunosorbent assay), and she was diagnosed with hyperinfection syndrome. Ivermectin 200 µg/kg daily was established.
It may be of interest to rule out a chronic infection in patients from risk areas (immigrants or those returning from recent trips) before starting treatment with corticosteroids.
类圆线虫病是一种由蠕虫感染引起的诊断不足且可预防的危及生命的疾病。慢性无症状感染可持续数十年，免疫抑制可导致播散性感染，死亡率为70%-100%。在神经外科人群中，皮质类固醇是导致超感染最常见的原因。
作者报告了一例33岁的巴拉圭裔女性病例，该患者被诊断为蝶骨平台脑膜瘤，并在此诊断基础上接受了高剂量皮质类固醇治疗。她接受了手术，病理解剖显示为I级脑膜瘤。术后，她开始出现呼吸困难、咳痰、发热和荨麻疹样皮疹。后来，她出现了肠道假性梗阻和细菌性脑膜炎合并脑积水。血清学检测（酶联免疫吸附测定）呈阳性，她被诊断为超感染综合征。开始每日给予伊维菌素200μg/kg。
在开始使用皮质类固醇治疗之前，对来自高危地区（移民或近期旅行归来者）的患者排除慢性类圆线虫感染可能是有意义的。
