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Rev. Inst. Med. Trop. Säo Paulo ; 52(3): 169-170, May-June 2010.
Article in English | LILACS | ID: lil-550353

ABSTRACT

A case of meningitis due to Staphylococcus warneri in a patient with a hyperinfection with Strongyloides stercoralis possibly associated with rituximab treatment for mantel cell lymphoma is reported for the first time in the literature. The patient was a 59-year-old woman, with a 3-year history of an apparently well controlled lymphoma after treatment with chemotherapy-immunotherapy and then immunotherapy alone, and diagnosis of strongyloidiasis. Meningitis was diagnosed by cerebrospinal fluid culture and tested with an automated plate system. The patient was successfully treated with vancomycin; although fever and productive cough persisted. Severe gastrointestinal symptoms and pneumonia developed three weeks later. Hyperinfection syndrome by S. stercoralis was diagnosed, with abundant larvae in feces and expectoration.


Caso de meningite por Staphylococcus warneri em paciente com hiperinfecção com Strongyloides stercoralis, possivelmente associada com tratamento de rituximab para linfoma de células do manto é relatada pela primeira vez na literatura. A paciente, mulher de 59 anos com história de três anos de linfoma aparentemente bem controlado com tratamento com quimioterapia-imunoterapia e, em seguida, somente imunoterapia e diagnóstico de estrongiloidíase. Meningite foi diagnosticada por cultura do líquido cefalorraquidiano e testada com sistema automatizado de placa. A paciente foi tratada com sucesso com vancomicina, embora a febre e a tosse produtiva não tenham desaparecido. Após graves sintomas gastrointestinais a paciente desenvolveu pneumonia três semanas mais tarde. Síndrome de hiperinfecção por S. stercoralis foi diagnosticada, com larvas abundantes nas fezes e expectoração.


Subject(s)
Animals , Female , Humans , Middle Aged , Lymphoma, Mantle-Cell/complications , Meningitis, Bacterial/complications , Staphylococcal Infections/complications , Strongyloides stercoralis/isolation & purification , Strongyloidiasis/complications , Superinfection/complications , Antibodies, Monoclonal/therapeutic use , Antineoplastic Agents/therapeutic use , Lymphoma, Mantle-Cell/drug therapy , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/microbiology , Severity of Illness Index , Staphylococcal Infections/diagnosis , Staphylococcal Infections/microbiology , Strongyloidiasis/diagnosis , Superinfection/diagnosis , Superinfection/drug therapy
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