Strongyloides stercoralis hyperinfection transmitted by liver allograft in a transplant recipient

TitleStrongyloides stercoralis hyperinfection transmitted by liver allograft in a transplant recipient
Publication TypeJournal Article
Year of Publication2009
AuthorsRodriguez-Hernandez MJ, Ruiz-Perez-Pipaon M, Canas E, Bernal C, Gavilan F
JournalAm J Transplant
Pagination2637 - 40
Date PublishedNov
ISSN1600-6143 (Electronic) 1600-6135 (Linking)
Accession Number19843038
Keywords*Strongyloides stercoralis, Aged, Albendazole / therapeutic use, Animals, Anthelmintics / therapeutic use, Antiparasitic Agents / therapeutic use, Humans, Ivermectin / therapeutic use, Liver Transplantation / *adverse effects, Male, Postoperative Complications / drug therapy / *parasitology, Strongyloidiasis / drug therapy / *transmission, Transplantation, Homologous

We describe a case of Strongyloides stercoralis hyperinfection in a liver allograft recipient 2.5 months after transplantation. The patient lives in Spain, which is not considered an endemic country for strongyloidiasis, and denied prior residence or travel to any known endemic area. The initial symptoms were fever and vomiting, and he subsequently developed a severe respiratory disease. An endoscopic biopsy of ulcerative lesions of the duodenum revealed massive mucosa infiltration by larvae and adult worms, which were also found in respiratory samples. The patient was successfully treated with combined therapy with albendazole and ivermectin. The strongyloides infection was transmitted by the liver allograft. The donor was from Ecuador and, retrospectively, his serum tested positive for S. stercoralis IgG antibodies. Additionally, the pancreas-left kidney allograft recipient from the same donor later developed an intestinal strongyloidiasis without hyperinfection syndrome. To our knowledge, this is the first confirmed case of S. stercoralis infection transmission from the same donor to two solid allograft recipients.

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