Disseminated strongyloidiasis caused by heart donor-to-host transmission presenting with purpura

Hattem, Simone van; Schuttelaar, Marielouise

doi:10.1111/j.1365-2230.2009.03740.x

Cited by 4 publications

(4 citation statements)

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“…Only four cases were reported from the whole of Africa [43-46], three of which in South Africa, a state where adequate diagnostic facilities are available. We collected 83/244 (34%) reports from North America (USA [47-109] and Canada [110-116]), 58/244 (24%) from Europe (Belgium [40,117], France [118-129], Germany [130,131], Greece [132-134], Italy [135-141], the Netherlands [142-145], Spain [146-155], Switzerland [156], UK [157-164]) and five (2%) from Oceania (Australia [165-168] and New Zealand [169]). In these areas of low/no endemicity, half of the patients were immigrants (70/146, 48%), while a few subjects were veterans (5/146, 3%) who presumably acquired the infection during military service in an endemic country.…”

Section: Resultsmentioning

confidence: 99%

“…A couple of patients who developed hyper infection also had co infection with CMV [21,107]. All the surviving patients received ivermectin, either as single treatment (1 patient) or in combination with albendazole (7) or thiabendazole (1) [29,54,60,71,90,92,94,142,145,150]. …”

Section: Resultsmentioning

confidence: 99%

“…Serology was performed only in 16/244 patients (6.5%) (Table 2). In a couple of organ transplant recipients, an ELISA test was negative pre-transplant, but resulted positive in the deceased donors (test performed retrospectively) [60,145]. In other two cases serology (ELISA) was negative: a HIV-infected person, who had larvae in stool and sputum [165] and a patient with dermatomyositis, under chronic treatment with prednisone and methotrexate, who died from disseminated strongyloidiasis (larvae found at autopsy in skin, lungs, small and large bowel, gall bladder, vessels of meninges and cervical spinal cord) [100].…”

Section: Resultsmentioning

confidence: 99%

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Severe strongyloidiasis: a systematic review of case reports

et al. 2013

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BackgroundStrongyloidiasis is commonly a clinically unapparent, chronic infection, but immuno suppressed subjects can develop fatal disease. We carried out a review of literature on hyperinfection syndrome (HS) and disseminated strongyloidiasis (DS), in order to describe the most challenging aspects of severe strongyloidiasis.MethodsWe conducted a structured search using PubMed to collect case reports and short case series on HS/DS published from 1991 to 2011. We restricted search to papers in English, Spanish, Italian and French. Case reports were classified as HS/DS according to given definitions.ResultsRecords screened were 821, and 311 were excluded through titles and abstract evaluation. Of 510 full-text articles assessed for eligibility, 213 were included in qualitative analysis. As some of them were short case series, eventually the number of cases analyzed was 244.Steroids represented the main trigger predisposing to HS and DS (67% cases): they were mostly administered to treat underlying conditions (e.g. lymphomas, rheumatic diseases). However, sometimes steroids were empirically prescribed to treat signs and symptoms caused by unsuspected/unrecognized strongyloidiasis. Diagnosis was obtained by microscopy examination in 100% cases, while serology was done in a few cases (6.5%). Only in 3/29 cases of solid organ/bone marrow transplantation there is mention of pre-transplant serological screening. Therapeutic regimens were different in terms of drugs selection and combination, administration route and duration. Similar fatality rate was observed between patients with DS (68.5%) and HS (60%).ConclusionsProper screening (which must include serology) is mandatory in high - risk patients, for instance candidates to immunosuppressive medications, currently or previously living in endemic countries. In some cases, presumptive treatment might be justified. Ivermectin is the gold standard for treatment, although the optimal dosage is not clearly defined in case of HS/DS.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Severe strongyloidiasis: a systematic review of case reports

et al. 2013

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“…Donor transmission of histoplasmosis,11 coccidioidomycosis,12 and strongyloidiasis,13 which are endemic to the Midwestern, Southwestern, and Southeastern United States, respectively, is fortunately very rare.…”

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confidence: 99%

Region-specific challenges for minimizing endemic donor-transmitted infections

Mossad

2011

Liver Transpl

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Imported Strongyloidiasis: Epidemiology, Presentations, and Treatment

Buonfrate

Angheben

Gobbi

et al. 2012

Curr Infect Dis Rep

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Strongyloidiasis is extremely more frequent in immigrants than in travellers. Clinical presentations do not differ significantly between the two groups, and the most frequent picture is a chronic infection characterized by intermittent, mild, non-specific symptoms. Acute presentation is rare but it has been reported in travellers. Screening of asymptomatic subjects is not generally recommended, while a presumptive treatment with ivermectin might be justified for all travellers and immigrant patients presenting unexplained eosinophilia and/or compatible symptoms, even in case of negative test results. In fact, delayed diagnosis and treatment has life-threatening consequences in patients with conditions predisposing to development of hyperinfection and dissemination.

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Disseminated strongyloidiasis caused by heart donor-to-host transmission presenting with purpura

Cited by 4 publications

References 6 publications

Severe strongyloidiasis: a systematic review of case reports

Severe strongyloidiasis: a systematic review of case reports

Region-specific challenges for minimizing endemic donor-transmitted infections

Imported Strongyloidiasis: Epidemiology, Presentations, and Treatment

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