Treatment of Strongyloides stercoralis hyperinfection-associated septic shock and acute respiratory distress syndrome with drotrecogin alfa (activated) in a renal transplant recipient

J M Huston; S R Eachempati; J R Rodney; C Cayci; D Fusco; M Mathew; J Shou; M J Goldstein; S Kapur; P S Barie

doi:10.1111/j.1399-3062.2009.00386.x

Treatment of Strongyloides stercoralis hyperinfection-associated septic shock and acute respiratory distress syndrome with drotrecogin alfa (activated) in a renal transplant recipient

Transpl Infect Dis. 2009 Jun;11(3):277-80. doi: 10.1111/j.1399-3062.2009.00386.x. Epub 2009 Apr 8.

Authors

J M Huston¹, S R Eachempati, J R Rodney, C Cayci, D Fusco, M Mathew, J Shou, M J Goldstein, S Kapur, P S Barie

Affiliation

¹ Department of Surgery, Division of Critical Care and Trauma, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York 10065, USA.

PMID: 19392733
DOI: 10.1111/j.1399-3062.2009.00386.x

Abstract

We report a case of Strongyloides stercoralis hyperinfection syndrome in a renal transplant recipient complicated by septic shock, acute respiratory distress syndrome, and Klebsiella pneumoniae superinfection. The patient was treated successfully with drotrecogin alfa (activated), parenteral ivermectin, albendazole, and piperacillin/tazobactam. This outcome suggests that drotrecogin alfa (activated) may be useful therapy for transplant recipients who develop severe sepsis or septic shock secondary to potentially lethal opportunistic infections.

Publication types

Case Reports

MeSH terms

Aged, 80 and over
Albendazole / therapeutic use
Animals
Anti-Infective Agents / therapeutic use
Drug Therapy, Combination
Female
Fibrinolytic Agents / administration & dosage
Fibrinolytic Agents / therapeutic use*
Humans
Ivermectin / therapeutic use
Kidney Transplantation / adverse effects*
Klebsiella Infections / complications
Klebsiella Infections / microbiology
Klebsiella pneumoniae / drug effects
Penicillanic Acid / analogs & derivatives
Penicillanic Acid / therapeutic use
Piperacillin / therapeutic use
Protein C / administration & dosage
Protein C / therapeutic use*
Recombinant Proteins / administration & dosage
Recombinant Proteins / therapeutic use
Respiratory Distress Syndrome / drug therapy*
Shock, Septic / drug therapy*
Strongyloides stercoralis / drug effects*
Strongyloidiasis / complications*
Strongyloidiasis / drug therapy
Strongyloidiasis / parasitology
Superinfection / complications*
Superinfection / microbiology
Superinfection / parasitology
Tazobactam
Treatment Outcome

Substances

Anti-Infective Agents
Fibrinolytic Agents
Protein C
Recombinant Proteins
Ivermectin
Penicillanic Acid
Albendazole
drotrecogin alfa activated
Tazobactam
Piperacillin