Encephalopathy after ivermectin treatment in a patient infected with Loa loa and Plasmodium spp.
Despite over 350 million people being safely treated with ivermectin, there have been rare cases of death post-treatment; these events are most often associated with high Loa loa microfilaremia. This first autopsy description of an encephalopathy case following the administration of ivermectin involves a 45-year-old male who became comatose 3 days after treatment. He slowly deteriorated over 5 weeks and died at 54 days after the anthelminthic treatment, probably as a result of a secondary skin or pulmonary infection exacerbated by malnutrition. The major pre- and post-autopsy findings included the presence of high loads of Loa loa, positivity for Plasmodium, the presence of a longstanding respiratory condition, and vascular pathology in the brain. The central nervous system lesions have similarities with those described in previously reported cases of Loa loa-associated death following diethylcarbamazine treatment.
Kamgno
Joseph
J
National Onchocerciasis Task Force, Yaounde, Cameroon. jkamgno@yahoo.fr
Boussinesq
Michel
M
Labrousse
François
F
Nkegoum
Blaise
B
Thylefors
Björn I
BI
Mackenzie
Charles D
CD
D000818:Animals; D000977:Antiparasitic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001927:Brain Diseases / Q000139:chemically induced* / Q000473:pathology; D002163:Cameroon; D017809:Fatal Outcome; D006801:Humans; D007559:Ivermectin / Q000009:adverse effects* / Q000627:therapeutic use; D008117:Loa / Q000254:growth & development / Q000302:isolation & purification; D008118:Loiasis / Q000150:complications / Q000188:drug therapy*; D008288:Malaria / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010961:Plasmodium / Q000254:growth & development / Q000302:isolation & purification
D000977:Antiparasitic Agents; D007559:Ivermectin