title: Treatment of Strongyloides stercoralis hyperinfection-associated septic shock and acute respiratory distress syndrome with drotrecogin alfa (activated) in a renal transplant recipient.
abstract: We report a case of Strongyloides stercoralis hyperinfection syndrome in a renal transplant recipient complicated by septic shock, acute respiratory distress syndrome, and Klebsiella pneumoniae superinfection. The patient was treated successfully with drotrecogin alfa (activated), parenteral ivermectin, albendazole, and piperacillin/tazobactam. This outcome suggests that drotrecogin alfa (activated) may be useful therapy for transplant recipients who develop severe sepsis or septic shock secondary to potentially lethal opportunistic infections.
authors.affiliation: Department of Surgery, Division of Critical Care and Trauma, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York 10065, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Huston
authors.forename: S R
authors.initials: SR
authors.lastname: Eachempati
authors.forename: J R
authors.initials: JR
authors.lastname: Rodney
authors.forename: C
authors.initials: C
authors.lastname: Cayci
authors.forename: D
authors.initials: D
authors.lastname: Fusco
authors.forename: M
authors.initials: M
authors.lastname: Mathew
authors.forename: J
authors.initials: J
authors.lastname: Shou
authors.forename: M J
authors.initials: MJ
authors.lastname: Goldstein
authors.forename: S
authors.initials: S
authors.lastname: Kapur
authors.forename: P S
authors.initials: PS
authors.lastname: Barie
mesh_terms: D000369:Aged, 80 and over; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D007710:Klebsiella Infections / Q000150:complications / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D011486:Protein C / Q000008:administration & dosage / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D012128:Respiratory Distress Syndrome / Q000188:drug therapy*; D012772:Shock, Septic / Q000188:drug therapy*; D017171:Strongyloides stercoralis / Q000187:drug effects*; D013322:Strongyloidiasis / Q000150:complications* / Q000188:drug therapy / Q000469:parasitology; D015163:Superinfection / Q000150:complications* / Q000382:microbiology / Q000469:parasitology; D000078142:Tazobactam; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D005343:Fibrinolytic Agents; D011486:Protein C; D011994:Recombinant Proteins; D007559:Ivermectin; D010397:Penicillanic Acid; D015766:Albendazole; C421124:drotrecogin alfa activated; D000078142:Tazobactam; D010878:Piperacillin