02673nas a2200289   4500008004100000020001400041024001400055245010800069210006900177260030400246300001600550490000700566520153400573653002802107653002802135653002702163653003002190100001602220700001602236700001302252700001302265700001602278700001502294700001302309700001602322856004502338       2013                        eng d  a1600-6135  a10096863800aStrongyloides stercoralis Transmission by Kidney Transplantation in Two Recipients From a Common Donor.0 aStrongyloides stercoralis Transmission by Kidney Transplantation  a(C) 1999?2012 John Wiley & Sons, Incb(1)Renal Section, Department of Medicine, Boston University Medical Center, Boston, MA,(2)Division of Infectious Diseases, Toronto General Hospital, Toronto, ON, Canada(3)Section of Gastroenterology, Department of Medicine, Boston University Medical Centec2013  a2483 - 24860 v133 a: Strongyloides stercoralis hyperinfection in an immunocompromised host has a high mortality rate but may initially present with nonspecific pulmonary and gastrointestinal symptoms. Donor-derived S. stercoralis by kidney transplantation is an uncommon diagnosis and difficult to prove. We report two renal allograft recipients on different immunosuppressive maintenance regimens that developed strongyloidiasis after transplantation from the same donor. Recipient 1 presented with a small bowel obstruction. Larvae were demonstrated on a duodenal biopsy and isolated from gastric, pulmonary, and stool samples. Serologic testing for S. stercoralis was negative at a referral laboratory but positive at the Centers for Disease Control. The patient's hospital course was complicated by a hyperinfection syndrome requiring subcutaneous ivermectin due to malabsorption. Recipient 1 survived but the allograft failed. Recipient 2 had larvae detected in stool samples after complaints of diarrhea and was treated. On retrospective testing for S. stercoralis, pretransplant serum collected from the donor and Recipient 1 was positive and negative, respectively. Donor-derived strongyloidiasis by renal transplantation is a preventable disease that may be affected by the immunosuppressive maintenance regimen. Subcutaneous ivermectin is an option in the setting of malabsorption. Finally, routine screening for S. stercoralis infection in donors from endemic areas may prevent future complications., (C) 1999?2012 John Wiley & Sons, Inc10aDonor-derived infection10aHyperinfection syndrome10aKidney Transplantation10aStrongyloides stercoralis1 aRoseman, D.1 aKabbani, D.1 aKwah, J.1 aBird, D.1 aIngalls, R.1 aGautam, A.1 aNuhn, M.1 aFrancis, J.  uhttps://notifylibrary.org/reference/4007