Strongyloidiasis pre and post autologous peripheral blood stem cell transplantation.
Hyperinfection with strongyloides stercolis occurs in the setting of chronic strongyloides infection in conjunction with immune suppression. Although malnutrition remains the major secondary cause worldwide in the developed world, iatrogenic immune suppression is an important precipitant. Autologous stem cell transplantation recipients are significantly immunocompromised albeit temporarily. Despite the increasing use of haemopoetic stem cell transplantation, hyperinfection with strongyloides has rarely been reported. We describe two cases of patients transplanted with chronic strongyloidiasis. In one case eradication therapy was given prior to the transplant which was uncomplicated. In the second case strongyloidiasis was diagnosed post transplant which was complicated by infection and respiratory compromise. Fatal hyperinfection subsequently developed after corticosteroid therapy was started for a disease progression in the CNS.
Orlent
H
H
Department of Haematology, Academisch Ziekenhuis Rotterdam, Dijkzigt, The Netherlands.
Crawley
C
C
Cwynarski
K
K
Dina
R
R
Apperley
J
J
D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D013322:Strongyloidiasis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D014182:Transplantation, Autologous
D000935:Antifungal Agents; D007166:Immunosuppressive Agents