Delayed Strongyloides stercoralis hyperinfection syndrome in a renal transplant patient with Pneumocystis jirovecii pneumonia receiving high-dose corticosteroids

Pan, Daniel; Arkell, Paul; Stone, Neil; Parkinson, Belinda; Tinwell, Brendan; Cosgrove, Catherine

doi:10.1016/s0140-6736(19)30708-1

Cited by 8 publications

(7 citation statements)

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“…A total of 72 studies 3,8–78 reported 91 SOT recipients, with 92 allografts and 93 episodes of S. stercoralis infection after SOT. There were 15 reports of S. stercoralis among HCT 45,79–92 .…”

Section: Resultsmentioning

confidence: 99%

“…There were 15 reports of S. stercoralis among HCT 45,79–92 . Overall, published studies originated predominantly from the US ( n = 43) 8,14,16–18,20,22,24,28,34–39,44,46,48,51–54,56,58,61,63–65,69,70,72,73,75 , 77,79,81,84,85,88–90,92 and Europe ( n = 18), 15,19,23,26,30,31,33,45,50,55,57,62,67 , 74,82,83,87,91 followed by the Asia‐Pacific region ( n = 15), 3,9–11 , 25,40–43,49,60,68,76,78,86 South America ( n = 9) 12,13,21,27,29,32,59,71,80 and Africa ( n = 1) 47…”

Section: Resultsmentioning

confidence: 99%

“…The majority of strongyloidiasis cases (70/93, [75.3%]) were reported among kidney transplant (KT) recipients (68/91[74.7%]), 9,10,12,13 , 15,17,18,21–23,25–30,35–43,45–47,49,51–54,56,57,59–64,66–70,72–78 of whom one underwent re‐transplantation (i.e., second kidney allograft) complicated by two additional infection episodes 30 . There were fewer reported cases of strongyloidiasis among liver ( n = 7[7.5%]), 3,8,11,20,33,44,71 heart/heart‐kidney ( n = 7, [7.5%]), 19,24,33,34,48,65,77 and kidney‐pancreas (KP) transplant ( n = 6[6.4%]) recipients 31,32,50,55,77 .…”

Section: Resultsmentioning

confidence: 99%

“…A total of 72 studies 3 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ,…”

Section: Resultsunclassified

“…The majority of strongyloidiasis cases (70/93, [75.3%]) were reported among kidney transplant (KT) recipients (68/91[74.7%]), 9,10,12,13,15,17,18,[21][22][23][25][26][27][28][29][30][35][36][37][38][39][40][41][42][43][45][46][47]49,[51][52][53][54]56,57,[59][60][61][62][63][64][66][67][68][69][70][72][73][74][75][76][77]…”

Section: Solid Organ Transplant Recipientsmentioning

confidence: 99%

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A comprehensive review of Strongyloides stercoralis infection after solid organ and hematopoietic stem cell transplantation

Abad

Bhaimia

Schuetz

et al. 2022

Clinical Transplantation

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Background:We reviewed the scientific literature to gain insight on the epidemiology and outcome of Strongyloides stercoralis infections after transplantation. Methods: CINAHL, PUBMED, and OVID/MEDLINE were reviewed from inception through March 31, 2022 using key words Strongyloides and transplantation. Results: Our review identified 108 episodes of Strongyloides infection among 91 solid organ transplant (SOT) and 15 hematopoietic cell transplant (HCT) recipients. Median time to infection was 10.8 (range, .14-417) and 8.8 (range, 0-208) weeks after SOT and HCT, respectively. Gastrointestinal symptoms were frequent (86/108 [79.6%]), while skin rash (22/108 [20.3%]) and fever (31/103 [30%]) were less common. Peripheral eosinophilia was observed in half of patients (41/77 [53.2%]). Bacteremia (31/59 [52.5%]) was frequently due to Gram-negative organisms (24/31 [77.4%]). Abnormal chest radiologic findings were reported in half (56/108 [51.9%]). The majority had hyperinfection syndrome (97/108 [89.8%]) while disseminated strongyloidiasis was less common (11/108 [10.2%]). Thirty-two cases were categorized as donorderived infection (DDI), with donors (23/24 [95.8%]) who had traveled to or lived in endemic areas. Median time to DDI was 8 weeks (range .5-34.3 weeks) after transplantation. Treatment consisted of ivermectin (n = 26), a benzimidazole (n = 27), or both drugs (n = 28). There was high all-cause mortality (48/107, 44.9%) and a high Strongyloides-attributable mortality (32/49, 65.3%).Conclusions: Strongyloidiasis should be strongly considered among recipients with epidemiologic risk factors for infection, even in the absence of eosinophilia or rash. A policy that provides guidance on pro-active screening is needed, to ensure preventive measures are provided to recipients at increased risk.

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Section: Resultsmentioning

confidence: 99%