Strongyloides stercoralis hyperinfection in hematopoietic stem cell transplantation.
Abstract: Strongyloides stercoralis is endemic in tropical, subtropical, and even temperate regions, and infects up to 100 million people worldwide. The diagnosis of strongyloidiasis can be difficult because of intermittent larval output in stool and nonspecific symptoms with mild peripheral eosinophilia. In this case report, a patient with acute myelogenous leukemia underwent peripheral blood hematopoietic stem cell transplantation (HSCT) and was subsequently diagnosed with strongyloidiasis. Strongyloidiasis should be considered in immunocompromised patients from endemic areas who have unexplained peripheral eosinophilia. If screening tests are positive for S. stercoralis or if a patient has unexplained eosinophilia with even a remote history of travel to or residence in endemic areas, then ivermectin should be given before HSCT to prevent often fatal hyperinfection syndrome from occurring after HSCT.
Wirk
B
B
Bone Marrow Transplant Program, Division of Hematology-Oncology, University of Florida College of Medicine, Gainesville, Florida 32610, USA. baldeep.wirk@medicine.ufl.edu
Wingard
J R
JR
D000328:Adult; D000818:Animals; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001992:Bronchoalveolar Lavage Fluid / Q000469:parasitology; D004802:Eosinophilia / Q000175:diagnosis / Q000276:immunology; D017809:Fatal Outcome; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007559:Ivermectin / Q000627:therapeutic use; D015479:Leukemia, Myelomonocytic, Acute / Q000601:surgery; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D015163:Superinfection / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000473:pathology
D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D007559:Ivermectin