TY - JOUR
T1 - Case report
T2 - Multiorgan dysfunction syndrome from strongyloides stercoralis hyperinfection in a patient with human T-cell lymphotropic virus-1 coinfection after initiation of ivermectin treatment
AU - Choksi, Tatvam T.
AU - Madison, Gul
AU - Dar, Tawseef
AU - Asif, Mohammed
AU - Fleming, Kevin
AU - Clarke, Leon
AU - Danilewitz, Mervyn
AU - Hennawy, Randa
N1 - Publisher Copyright:
Copyright © 2016 by The American Society of Tropical Medicine and Hygiene.
PY - 2016/10
Y1 - 2016/10
N2 - Strongyloides stercoralis is well known to cause hyperinfection syndrome during the period of immunosuppression; but dissemination, worsening hyperinfection, and development of multiorgan dysfunction syndrome after initiation of ivermectin has not been reported in the past. Herein, we describe the case of a 62-year-old man with chronic strongyloidiasis and human T-cell lymphotropic virus-1 coinfection, who developed significant clinical worsening after 24-48 hours of initiation of treatment with ivermectin (200 μg/kg daily). Oral albendazole (600 mg every 12 hours) was added to the regimen due to clinical deterioration. Notably, after a protracted clinical course with multiple complications, which included respiratory failure from gram-negative pneumonia and pulmonary alveolar hemorrhage, Klebsiella meningitis, Clostridium difficile colitis, and herpes labialis, the patient eventually recovered. Health-care providers should be aware that during the early days of antihelminthic treatment initiation, significant dissemination of S. stercoralis and worsening of the clinical scenario can occur.
AB - Strongyloides stercoralis is well known to cause hyperinfection syndrome during the period of immunosuppression; but dissemination, worsening hyperinfection, and development of multiorgan dysfunction syndrome after initiation of ivermectin has not been reported in the past. Herein, we describe the case of a 62-year-old man with chronic strongyloidiasis and human T-cell lymphotropic virus-1 coinfection, who developed significant clinical worsening after 24-48 hours of initiation of treatment with ivermectin (200 μg/kg daily). Oral albendazole (600 mg every 12 hours) was added to the regimen due to clinical deterioration. Notably, after a protracted clinical course with multiple complications, which included respiratory failure from gram-negative pneumonia and pulmonary alveolar hemorrhage, Klebsiella meningitis, Clostridium difficile colitis, and herpes labialis, the patient eventually recovered. Health-care providers should be aware that during the early days of antihelminthic treatment initiation, significant dissemination of S. stercoralis and worsening of the clinical scenario can occur.
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U2 - 10.4269/ajtmh.16-0259
DO - 10.4269/ajtmh.16-0259
M3 - Article
C2 - 27527631
AN - SCOPUS:84990236882
SN - 0002-9637
VL - 95
SP - 864
EP - 867
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 4
ER -