An unusual cause of alveolar hemorrhage post hematopoietic stem cell transplantation: a case report.
BACKGROUND
Hematopoietic stem cell transplantation is being increasingly used in cancer therapy. Diffuse alveolar hemorrhage, an early complication of stem cell transplant, results from bacterial, viral and fungal infections, coagulopathy, and engraftment syndrome, or can be idiopathic. Diffuse alveolar hemorrhage associated with Strongyloides stercoralis hyperinfection in stem cell transplant patients has been rarely reported.


METHODS
We describe an unusual cause of alveolar hemorrhage post hematopoietic stem cell transplant due to Strongyloides hyperinfection. Therapy with parenteral ivermectin and thiabendazole was initiated but the patient deteriorated and died of respiratory failure and septic shock.


CONCLUSIONS
Strongyloides stercoralis hyperinfection is an unusual cause of alveolar hemorrhage early after hematopoietic stem cell transplant with very high mortality.
Gupta
Sachin
S
Department of Pulmonary Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA. sachin.gupta@uth.tmc.edu
Jain
Amit
A
Fanning
Tina V
TV
Couriel
Daniel R
DR
Jimenez
Carlos A
CA
Eapen
Georgie A
GA
D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D018380:Hematopoietic Stem Cell Transplantation; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D016867:Immunocompromised Host; D007559:Ivermectin / Q000627:therapeutic use; D007710:Klebsiella Infections / Q000150:complications / Q000188:drug therapy; D008174:Lung Diseases, Parasitic / Q000150:complications* / Q000188:drug therapy / Q000469:parasitology; D008224:Lymphoma, Follicular / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011650:Pulmonary Alveoli / Q000469:parasitology / Q000473:pathology; D018805:Sepsis / Q000150:complications / Q000188:drug therapy; D012772:Shock, Septic / Q000209:etiology; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000150:complications* / Q000188:drug therapy; D013827:Thiabendazole / Q000627:therapeutic use
D000890:Anti-Infective Agents; D007559:Ivermectin; D013827:Thiabendazole