Steptococcus bovis meningitis and sepsis associated with Strongyloidiasis in an immunocompetent patient.

We report the case of a 69-year-old female who presented with headache, stiff neck, and decreased level of consciousness. Lumbar puncture results were typical of bacterial meningitis. Blood and cerebrospinal fluid cultures showed Streptococcus bovis. Subsequent serologic studies indicated concurrent Strongyloides stercoralis infection, and larvae were visualized in two separate stool specimens. The patient responded to treatment of both infections. She refused to undergo colonoscopy despite a known association between Streptococcus bovis and colonic carcinoma.