title: Strongyloides disseminated infection successfully treated with parenteral ivermectin: case report with drug concentration measurements and review of the literature.
abstract: We report the case of an immunosuppressed patient with Strongyloides disseminated infection who was successfully treated with the veterinary parenteral form of ivermectin. A kidney transplant recipient developed disseminated infection with Strongyloides stercoralis. Because oral treatment with ivermectin was not possible, subcutaneous ivermectin (75 µg/kg/day, then 200 µg/kg/day) was given for 9 days, with clinical improvement and disappearance of all larvae. Serum ivermectin concentrations were between 15.6 ng/mL and 19.7 ng/mL during the 9 days of therapy; however, drug accumulation (plasma levels >40 ng/mL) 48 h after discontinuation of therapy was associated with the development with encephalopathy. We also review all cases of human disseminated Strongyloides infection treated with parenteral ivermectin.
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Katia
authors.initials: K
authors.lastname: Donadello
authors.forename: Stefano
authors.initials: S
authors.lastname: Cristallini
authors.forename: Fabio Silvio
authors.initials: FS
authors.lastname: Taccone
authors.forename: Sophie
authors.initials: S
authors.lastname: Lorent
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
authors.forename: Daniel
authors.initials: D
authors.lastname: de Backer
authors.forename: Frédérique
authors.initials: F
authors.lastname: Jacobs
mesh_terms: D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D007279:Injections, Subcutaneous; D007559:Ivermectin / Q000008:administration & dosage* / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D044967:Serum / Q000737:chemistry; D017171:Strongyloides stercoralis / Q000187:drug effects*; D013322:Strongyloidiasis / Q000188:drug therapy* / Q000469:parasitology; D016896:Treatment Outcome
chemical_list: D000871:Anthelmintics; D007559:Ivermectin
keywords: Disseminated infection; Hyperinfection; Ivermectin; Serum concentration; Strongyloides stercoralis