1. Strongyloides hyper-infection in a lung transplant recipient: Case report and review of the literature.
- Author
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Meira Dias O, Belousova N, Sharif N, Brasg I, Singer LG, Tikkanen J, Chaparro C, and Rotstein C
- Abstract
Case Presentation: A 63-year-old man with a left single lung transplant for end-stage combined restrictive and obstructive lung disease developed persistent pulmonary infiltrates and recurrent gram-negative bacteremia post-transplant. Bronchoalveolar lavage fluid revealed a nematode on Papanicolau staining compatible with Strongyloides stercoralis larvae on day 50 post-transplant. Although Strongyloides serology performed post-transplant was negative, a retrospective review of the medical record revealed marked peripheral blood eosinophilia on several occasions before transplantation. Despite reduction in immunosuppression and treatment with albendazole and ivermectin, the patient developed another episode of Escherichia coli bacteremia. He died 3 months post-transplant from pulmonary and neurological complications., Diagnosis: Strongyloides hyper-infection., Discussion: Strongyloides hyper-infection syndrome is known to occur in immunocompromised patients, but it has only been reported once in a lung transplant recipient. This case illustrates the importance of screening for parasitic infections before transplantation in patients with marked eosinophilia, especially among immigrants from countries in which Strongyloides is endemic. Hyper-infection syndrome may appear years after infection in the context of immunosuppression or immunodeficiency. This case also highlights the association between Strongyloides hyper-infection and bacteremia with enteric organisms., Competing Interests: N Belousova received financial assistance for attending the ISHLT 2022 meeting; C Rotstein has received grants or contracts from Cidara, Merck Canada Inc., and Pfizer Canada Inc. He has received consulting fees from Avir Pharma and Merck Canada Inc. and payment or honoraria from Roche Pharma Canada, Sunovion Pharmaceuticals Canada, and Merck Canada Inc. The other authors have nothing to disclose., (Copyright © 2022, Association of Medical Microbiology and Infectious Disease Canada (AMMI Canada).)
- Published
- 2022
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