{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:41:30Z","timestamp":1760175690955,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,3,12]],"date-time":"2020-03-12T00:00:00Z","timestamp":1583971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>An elderly Singaporean male with no travel history was hospitalized for fever and altered mental status. Blood cultures grew Enterococcus faecalis, and given a preceding history of steroid use and peripheral eosinophilia, Strongyloides hyperinfection was suspected. Stool specimens were positive for Strongyloides stercoralis larvae over four days, and larvae were also isolated in an early morning nasogastric aspirate specimen prior to initiation of ivermectin. A cerebrospinal fluid examination was consistent with partially treated bacterial meningitis and ventriculitis was demonstrated on neuroimaging. In view of a persistent fever, a further imaging evaluation was performed, which demonstrated bilateral pneumonia as well as the unusual finding of gas-forming emphysematous spondylodiscitis and left psoas abscesses. Despite the early suspicion of Strongyloides hyperinfection, commencement of appropriate antibiotics and anti-helminthics, microbiological clearance of bacteremia as well as clearance of S. stercoralis from the stool, the patient still succumbed to infection and passed away 11 days after admission.<\/jats:p>","DOI":"10.3390\/tropicalmed5010044","type":"journal-article","created":{"date-parts":[[2020,3,12]],"date-time":"2020-03-12T12:22:51Z","timestamp":1584015771000},"page":"44","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Strongyloides Hyperinfection Associated with Enterococcus faecalis Bacteremia, Meningitis, Ventriculitis and Gas-Forming Spondylodiscitis: A Case Report"],"prefix":"10.3390","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6428-9999","authenticated-orcid":false,"given":"Liang En","family":"Wee","sequence":"first","affiliation":[{"name":"Singhealth Infectious Diseases Residency, Singapore 168753, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su Wai Khin","family":"Hnin","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Neuroscience Institute, Singapore 308433, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheyu","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Neuroscience Institute, Singapore 308433, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence Soon-U","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore 308433, Singapore"},{"name":"Department of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,3,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s12639-019-01090-x","article-title":"Strongyloides stercoralis hyperinfection syndrome: A deeper understanding of a neglected disease","volume":"43","author":"Marin","year":"2019","journal-title":"J. Parasit. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1017\/S0031182016000834","article-title":"Human infection with Strongyloides stercoralis and other related Strongyloides species","volume":"144","author":"Nutman","year":"2017","journal-title":"Parasitology"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Buonfrate, D., Requena-Mendez, A., Angheben, A., Mu\u00f1oz, J., Gobbi, F., Van Den Ende, J., and Bisoffi, Z. (2013). Severe strongyloidiasis: A systematic review of case reports. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-78"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"365","DOI":"10.47102\/annals-acadmedsg.V33N3p365","article-title":"An unusual cause of pulmonary haemorrhage in a patient with rheumatoid arthritis","volume":"33","author":"Koh","year":"2004","journal-title":"Ann. Acad. Med. 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