title: Hyperinfection strongyloidiasis in a liver transplant recipient treated with parenteral ivermectin.
abstract: Severe strongyloidiasis, including hyperinfection and dissemination, is a recognized complication of solid organ transplantation. However, the development of strongyloidiasis in a liver transplant recipient has not been previously described. We present a case of severe strongyloidiasis occurring in a patient 4 months after liver transplantation and 1 month after receiving treatment for acute rejection. We assess the management challenges in this patient who remained symptomatic despite oral treatment with ivermectin and albendazole and eventual successful treatment with parenteral ivermectin. We review the published experience with alternative methods of ivermectin administration. We also investigate the possible source of infection, as the patient was not from an endemic area.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine and Jackson Memorial Hospital, Miami, Florida 33136, USA.
authors.forename: P
authors.initials: P
authors.lastname: Lichtenberger
authors.forename: I
authors.initials: I
authors.lastname: Rosa-Cunha
authors.forename: M
authors.initials: M
authors.lastname: Morris
authors.forename: S
authors.initials: S
authors.lastname: Nishida
authors.forename: E
authors.initials: E
authors.lastname: Akpinar
authors.forename: J
authors.initials: J
authors.lastname: Gaitan
authors.forename: A
authors.initials: A
authors.lastname: Tzakis
authors.forename: S
authors.initials: S
authors.lastname: Doblecki-Lewis
mesh_terms: D000284:Administration, Oral; D015766:Albendazole / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007279:Injections, Subcutaneous; D007559:Ivermectin / Q000008:administration & dosage / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology / Q000469:parasitology; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000188:drug therapy* / Q000209:etiology; D015163:Superinfection / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000871:Anthelmintics; D007166:Immunosuppressive Agents; D007559:Ivermectin; D015766:Albendazole