Persistent strongyloidiasis complicated by recurrent meningitis in an HTLV seropositive Peruvian migrant resettled in Italy

Tordini, Giacinta; Zammarchi, Lorenzo; Gotuzzo Herencia, José Eduardo; Bisoffi, Zeno; Bartoloni, Alessandro; Montagnani, Francesca; De Luca, Andrea

dc.contributor.author	Zammarchi, Lorenzo
dc.contributor.author	Montagnani, Francesca
dc.contributor.author	Tordini, Giacinta
dc.contributor.author	Gotuzzo Herencia, José Eduardo
dc.contributor.author	Bisoffi, Zeno
dc.contributor.author	Bartoloni, Alessandro
dc.contributor.author	De Luca, Andrea
dc.date.accessioned	2019-02-06T14:57:38Z
dc.date.available	2019-02-06T14:57:38Z
dc.date.issued	2015
dc.identifier.uri	https://hdl.handle.net/20.500.12866/5477
dc.description.abstract	We describe a case of persistent strongyloidiasis complicated by recurrent meningitis, in a human T cell lymphotropic virus type 1 (HTLV-1) seropositive Peruvian migrant adult resettled in Italy. He was admitted with signs and symptoms of acute bacterial meningitis, reporting four other meningitis episodes in the past 6 years, with an etiological diagnosis of Escherichia coli and Enterococcus faecium in two cases. He had been previously treated with several antihelmintic regimens not including ivermectin, without eradication of strongyloidiasis, and he had never been tested for HTLV before. During the described episode, the patient was treated for meningitis with broad-spectrum antibiotic therapy and 200 mug/kg/dose oral ivermectin once daily on day 1, 2, 15 and 16 with full recovery and no further episodes of meningitis. The presented case underlines several critical points concerning the management of poorly known neglected diseases such as strongyloidiasis and HTLV infection in low-endemic areas. Despite several admissions for meningitis and strongyloidiasis, the parasitic infection was not adequately treated and the patient was not previously tested for HTLV. The supply of ivermectin and the choice of treatment scheme was challenging since ivermectin is not approved in Italy and there are no standardized guidelines for the treatment of severe strongyloidiasis in HTLV seropositive subjects.	en_US
dc.language.iso	eng
dc.publisher	American Society of Tropical Medicine and Hygiene
dc.relation.ispartofseries	American Journal of Tropical Medicine and Hygiene (ASTMH Journal)
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	Adult	en_US
dc.subject	Humans	en_US
dc.subject	Male	en_US
dc.subject	Human T-lymphotropic virus 1	en_US
dc.subject	Recurrence	en_US
dc.subject	Peru/ethnology	en_US
dc.subject	Coinfection/parasitology/virology	en_US
dc.subject	HTLV-I Infections/complications/parasitology	en_US
dc.subject	Italy/epidemiology	en_US
dc.subject	Meningitis, Viral/complications/parasitology/virology	en_US
dc.subject	Strongyloidiasis/complications/virology	en_US
dc.title	Persistent strongyloidiasis complicated by recurrent meningitis in an HTLV seropositive Peruvian migrant resettled in Italy	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.4269/ajtmh.14-0716
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn	1476-1645