Successful Treatment of Strongyloides stercoralis Hyperinfection in a Kidney Transplant Recipient: Case Report

Transplant Proc. 2018 Apr;50(3):861-866. doi: 10.1016/j.transproceed.2018.02.019.

Abstract

Strongyloides stercoralis (SS) can cause hyperinfection and disseminated infection in immunosuppressed individuals, with risk of mortality. We report the case of a cadaveric kidney transplant recipient who developed gastrointestinal symptoms and eosinophilia, approximately 3 months after transplantation. Stool examination and esophagogastroduodenoscopy with biopsies were positive for SS larvae. The patient was started on oral ivermectin and immunosuppression was reduced, but still the clinical picture got worse with metabolic ileus and respiratory symptoms, with the need for administration of subcutaneous ivermectin and combined therapy with albendazol. The patient survived and graft function was preserved. The patient was unlikely to be the source of infection. We also present a review of cases of SS infection in kidney transplant recipients.

Publication types

  • Case Reports

MeSH terms

  • Albendazole / therapeutic use
  • Animals
  • Antiparasitic Agents / therapeutic use
  • Biopsy
  • Drug Therapy, Combination
  • Eosinophilia / immunology*
  • Eosinophilia / parasitology
  • Humans
  • Immunocompromised Host*
  • Immunosuppression Therapy / methods
  • Ivermectin / therapeutic use
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications / drug therapy
  • Postoperative Complications / immunology*
  • Postoperative Complications / parasitology
  • Strongyloides stercoralis
  • Strongyloidiasis / drug therapy
  • Strongyloidiasis / immunology*
  • Strongyloidiasis / parasitology
  • Superinfection / drug therapy
  • Superinfection / immunology*
  • Superinfection / parasitology

Substances

  • Antiparasitic Agents
  • Ivermectin
  • Albendazole