Strongyloides carry bacteria that attack the man’s brain

On August 3, a representative of the Central Tropical Diseases Hospital said that the symptoms appeared about 2 days before admission. The results of a lumbar puncture at the provincial hospital recorded an increase in cells and proteins in the cerebrospinal fluid, leading to a diagnosis of purulent meningitis.

Despite aggressive treatment, the patient’s condition deteriorated very quickly, falling into severe septic shock, hypotension, requiring intubation, mechanical ventilation and the use of high doses of vasopressors. After two days, the patient was transferred to the Intensive Care Center, Central Tropical Diseases Hospital in critical condition.

Doctor Nguyen Duc Hieu, Intensive Care Center, said that immediately upon receipt, the doctor re-aspirated the cerebrospinal fluid to identify the causative agent, and the results identified E. coli bacteria as the cause of meningitis. However, this is a bacteria that normally resides in the digestive tract but appears in the cerebrospinal fluid.

Doctors continued to expand testing, and the results showed that the patient was positive for strongyloides. According to Dr. Hieu, strongyloides do not directly cause purulent meningitis. However, medical literature has recorded that in cases of hyperinfection or disseminated strongyloidiasis, the worm larvae, when penetrating the intestinal wall and entering the bloodstream, can carry intestinal Gram-negative bacteria, typically E. coli. From there, bacteria can cause sepsis and even meningitis.

Strongyloides are a type of parasite that can re-infect itself and maintain a life cycle in the human body for many years without causing obvious symptoms. When resistance is reduced, especially in the elderly or with underlying diseases such as cirrhosis, parasites can multiply rapidly, increasing the risk of serious infectious complications.

After being treated with antibiotics according to the antibiogram, combined with strongyloides treatment and intensive resuscitation, the patient’s infection status as well as cerebrospinal fluid indicators gradually improved.

Normally, healthy people infected with strongyloides only show mild illnesses such as digestive disorders, rashes, fatigue, and loss of appetite. People with immunodeficiency and long-term use of corticosteroids or immunosuppressants are at risk of developing strongyloidiasis syndrome or disseminated strongyloidiasis. At that time, the worm larvae invade many organs such as the heart, liver, lungs, kidneys, and brain, showing serious, life-threatening infections and very difficult and expensive treatment.

Doctors advise people not to be subjective about parasitic diseases. When symptoms such as fever, severe headache, vomiting, drowsiness or confusion appear, you should immediately go to a medical facility for examination.