A fatal case of strongyloidiasis with Strongyloides larvae in the meninges

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Abstract
A case of fatal strongyloidiasis associated with pyogenic meningitis in an adult male African is reported. Strongyloides larvae were present in the purulent exudate in the meninges, an observation not, to the authors' knowledge, hitherto reported in man. Fatal strongyloidiasis due to autoinfection has been reported by several authors and De Paula (1962) reviewed the literature in 40 cases and added 10 others which he had studied. In Uganda fatal cases have been reported by Cravenet al. (1971) and Poltera (1974). Although in some cases of fatal strongyloidiasis there was associated pyogenic meningitis ( Brown & Perna, 1958; Wilson & Thompson, 1964; Bassan-Treminger & el-Lanshar, 1968) we have not found in the literature any case in which Strongyloides stercoralis larvae or adult worms were found in the brain or meninges. We are, therefore, now reporting a case of fatal strongyloidiasis with pyogenic meningitis in which S. stercoralis larvae were present in the subarachnoid space.

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