Abstract
Severe strongyloidiasis, including hyperinfection and dissemination, is a recognized complication of solid organ transplantation. However, the development of strongyloidiasis in a liver transplant recipient has not been previously described. We present a case of severe strongyloidiasis occurring in a patient 4 months after liver transplantation and 1 month after receiving treatment for acute rejection. We assess the management challenges in this patient who remained symptomatic despite oral treatment with ivermectin and albendazole and eventual successful treatment with parenteral ivermectin. We review the published experience with alternative methods of ivermectin administration. We also investigate the possible source of infection, as the patient was not from an endemic area.
MeSH terms
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Administration, Oral
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Albendazole / administration & dosage
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Albendazole / therapeutic use
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Animals
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Anthelmintics / administration & dosage
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Anthelmintics / therapeutic use*
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Female
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Graft Rejection / prevention & control
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Humans
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Immunosuppressive Agents / adverse effects
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Immunosuppressive Agents / therapeutic use
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Injections, Subcutaneous
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Ivermectin / administration & dosage
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Ivermectin / therapeutic use*
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Liver Transplantation / adverse effects*
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Middle Aged
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Postoperative Complications / drug therapy*
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Postoperative Complications / etiology
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Postoperative Complications / parasitology
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Strongyloides stercoralis*
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Strongyloidiasis / drug therapy*
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Strongyloidiasis / etiology
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Superinfection / drug therapy*
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Superinfection / etiology
Substances
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Anthelmintics
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Immunosuppressive Agents
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Ivermectin
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Albendazole