title: Fatal outcome of a hyperinfection syndrome despite successful eradication of Strongyloides with subcutaneous ivermectin.
abstract: We report the case of a 77-year-old man who developed a Strongyloides hyperinfection syndrome following immunosuppressive therapy more than 60 years after he moved away from an area endemic for Strongyloides stercoralis. Successful eradication of the nematode was achieved with an off label subcutaneous formulation of ivermectin. However, the patient subsequently died from acute respiratory distress syndrome (ARDS). Despite a high wormload in the stool and sputum of the patient and delayed infection control measures in the hospital, testing of the medical staff revealed a very low risk of Strongyloides transmission among healthcare workers.
authors.affiliation: Medical Clinic, Research Center Borstel, Parkallee 35, 23845 Borstel, Germany.
authors.forename: H P
authors.initials: HP
authors.lastname: Hauber
authors.forename: J
authors.initials: J
authors.lastname: Galle
authors.forename: P L
authors.initials: PL
authors.lastname: Chiodini
authors.forename: J
authors.initials: J
authors.lastname: Rupp
authors.forename: R
authors.initials: R
authors.lastname: Birke
authors.forename: E
authors.initials: E
authors.lastname: Vollmer
authors.forename: P
authors.initials: P
authors.lastname: Zabel
authors.forename: C
authors.initials: C
authors.lastname: Lange
mesh_terms: D000368:Aged; D000818:Animals; D000969:Antinematodal Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D017809:Fatal Outcome; D005243:Feces / Q000469:parasitology; D006801:Humans; D007279:Injections, Subcutaneous; D007559:Ivermectin / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D012128:Respiratory Distress Syndrome; D013183:Sputum / Q000469:parasitology; D017171:Strongyloides stercoralis / Q000302:isolation & purification; D013322:Strongyloidiasis / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000969:Antinematodal Agents; D007559:Ivermectin