Case report: Multiorgan dysfunction syndrome from strongyloides stercoralis hyperinfection in a patient with human T-cell lymphotropic virus-1 coinfection after initiation of ivermectin treatment

Tatvam T. Choksi, Gul Madison, Tawseef Dar, Mohammed Asif, Kevin Fleming, Leon Clarke, Mervyn Danilewitz, Randa Hennawy

Research output: Contribution to journalArticlepeer-review

Abstract

Strongyloides stercoralis is well known to cause hyperinfection syndrome during the period of immunosuppression; but dissemination, worsening hyperinfection, and development of multiorgan dysfunction syndrome after initiation of ivermectin has not been reported in the past. Herein, we describe the case of a 62-year-old man with chronic strongyloidiasis and human T-cell lymphotropic virus-1 coinfection, who developed significant clinical worsening after 24-48 hours of initiation of treatment with ivermectin (200 μg/kg daily). Oral albendazole (600 mg every 12 hours) was added to the regimen due to clinical deterioration. Notably, after a protracted clinical course with multiple complications, which included respiratory failure from gram-negative pneumonia and pulmonary alveolar hemorrhage, Klebsiella meningitis, Clostridium difficile colitis, and herpes labialis, the patient eventually recovered. Health-care providers should be aware that during the early days of antihelminthic treatment initiation, significant dissemination of S. stercoralis and worsening of the clinical scenario can occur.

Original languageEnglish (US)
Pages (from-to)864-867
Number of pages4
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume95
Issue number4
DOIs
StatePublished - Oct 2016
Externally publishedYes

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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