A Case Report of Meningitis and Sepsis due to Enterococcus faecium complicated with Strongyloidiasis

A 80 year-old male was transferred to our department on 18th Aug. 1988, for high fever and clouding of the consciousness., He had been treated with steroid hormone (betamethazone 3.0 mg/day for 15 days) for his uveitis. Enterococcus faecium was isolatd from both blood and spinal fluid, and then Strongyloides stercoralis was revealed both in the sputum and stool. Anti-Human T-cell leukemia virus 1 (HTLV-1) antibody was also positive serologically. At first, β-lactam antibiotics were used for the treatment of purulent meningitis and sepsis, but after performing sensitivity tests for E. faecium, the antibiotics were changed to rifampicin (RFP), fosfomycin (FOM) and ofloxacin (OFLX) for their excellent activity against the organism. After the clinical symptoms, subsided, thiabendazole was used for disseminated stronglyoidiasis in daily dosas of 2, 500 mg for six days initially. The drug ws used three times with two week intervals. Both bacterial and parasite infections subsided and no recurrence has been noticed until now. This is the first case of meningitis caused by E. facium complicated with strongyloidiasis.