Adverse Occurrence type:
Time to detection:
< 9 months
Alerting signals, symptoms, evidence of occurrence:
Risk mostly related to chronic intestinal Strongyloides infection. Rare transmission through transplant, reported in kidney, pancreas, intestine. Classical clinic: hyperinfection syndrome with worsening of pulmonary function, starting with wheezing and eventually progression to an ARDS–like picture, with respiratory failure and death. Many patients have concurrently gastrointestinal symptoms, including abdominal pain, dyspepsia, diarrhea, or constipation, or severe manifestations including ileus, obstruction and GI bleeding. Classical complication: gram-negative enteric bacteria sepsis, caused by larvae migrating from the bowel through the venous system (-> meningitis, cholecystitis, liver abscess, pancreatitis). Time of Onset: up to 9 months. Eosinophilia not always present. High mortality rate!
Demonstration of imputability or root cause:
Hyperinfection in recipient with donor with exposure to high risk location and/or positive serology