Strongyloides Stercoralis infection associated with repititive bacterial meningitis and SIADH : a case report

Strongyloidiasis is an infection by the intestinal parasite Strongyloides Stercoralis, which usually stays asymptomatic. In some situations a hyperinfection or disseminated disease can occur. We report a case of a 49-year-old Congolese man with a medical history of 5 episodes of bacterial meningitis, who presents himself with a paralytic ileus and a low serum sodium. A Strongyloides hyperinfection with a SIADH was diagnosed. After treatment with ivermectine the abdominal symptoms subsided and the serum sodi- um returned to normal values. In comparison to other case reports our patient had no respiratory or gastrointestinal symptoms during the episodes of bacterial meningitis. Screening for Strongyloides stercoralis is indicated in patients with unexplained SIADH, bacterial meningitis or bacterial septicaemia, who origi- nally come from endemic countries. (Acta gastroenterol. belg., 2008, 71, 000-000).