Periumbilical parasitic thumbprint purpura: <i>Strongyloides</i> hyperinfection syndrome acquired from a cadaveric renal transplant

Weiser, Jessica A.; Scully, Brian E.; Bulman, William A.; Husain, S. Ali; Grossman, Marc E.

doi:10.1111/j.1399-3062.2010.00516.x

Cited by 45 publications

(56 citation statements)

References 25 publications

(35 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(13) Two cases emerged in 2011 providing evidence of donor transmission based on positive donor serology. (2, 14) In the first case, a deceased Honduran woman donated both kidneys and a liver. One kidney recipient was diagnosed with strongyloidiasis.…”

Section: Discussionmentioning

confidence: 99%

Strongyloides stercoralis Transmission by Kidney Transplantation in Two Recipients From a Common Donor

Roseman

Kabbani

Kwah

et al. 2013

American Journal of Transplantation

View full text Add to dashboard Cite

Strongyloides stercoralis hyperinfection in an immunocompromised host has a high mortality rate but may initially present with non-specific pulmonary and gastrointestinal symptoms. Donor-derived S. stercoralis by kidney transplantation is an uncommon diagnosis and difficult to prove. We report two renal allograft recipients on different immunosuppressive maintenance regimens that developed strongyloidiasis after transplantation from the same donor. Recipient 1 presented with a small bowel obstruction. Larvae were demonstrated on a duodenal biopsy and isolated from gastric, pulmonary, and stool samples. Serologic testing for S. stercoralis was negative at a referral laboratory but positive at the Centers for Disease Control. The patient's hospital course was complicated by a hyperinfection syndrome requiring subcutaneous ivermectin due to malabsorption. Recipient 1 survived but the allograft failed. Recipient 2 had larvae detected in stool samples after complaints of diarrhea and was treated. On retrospective testing for S. stercoralis, pre-transplant serum collected from the donor and Recipient 1 was positive and negative, respectively. Donor-derived strongyloidiasis by renal transplantation is a preventable disease that may be affected by the immunosuppressive maintenance regimen. Subcutaneous ivermectin is an option in the setting of malabsorption. Finally, routine screening for S. stercoralis infection in donors from endemic areas may prevent future complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Strongyloides stercoralis Transmission by Kidney Transplantation in Two Recipients From a Common Donor

Roseman

Kabbani

Kwah

et al. 2013

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

“…This finding raises a particular concern because a high number of Donors also can transmit the infection. A cadaveric kidney donor transmitted Strongyloides to the recipient [75]. Another case of intestinal transplant from a middleaged woman from Central America (donor) was suspected as the source of HS in the recipient, who died [76•].…”

Section: Strongyloides Infection In the Transplanted Patientmentioning

confidence: 99%

Update on Strongyloidiasis in the Immunocompromised Host

Marcos

Terashima

Canales

et al. 2010

Curr Infect Dis Rep

143

126

View full text Add to dashboard Cite

Immunocompromised persons are the most vulnerable population at risk for developing life-threatening clinical syndromes associated with strongyloidiasis, such as hyperinfection syndrome (HS) or dissemination. This review focuses on describing Strongyloides infection in the immunocompromised host, including immune response against this infection, analyzing the cases with HS published during the past 4 years in the United States, and describing the most sensitive diagnostic tools and the most effective treatment for each clinical syndrome. Strongyloidiasis is becoming an important parasitic disease in the United States, especially in the immunocompromised immigrant population. Because the transplant population is particularly at risk for developing HS, both recipients and donors should be screened for Strongyloides. Clinicians should also be aware that the development of HS can follow unexpectedly a few days after appropriate anthelminthic therapy. Highly sensitive screening tests are still not available in the major tertiary medical centers. Parenteral ivermectin has been used in some severe cases. Further therapy developments and improving diagnostic tools are warranted.

show abstract

“…Organ donors have also been shown to transmit Strongyloides infection with cases of solid organ transplant-associated S. stercoralis infections having been reported (Weiser et al 2011). …”

Section: Clinical Manifestationsmentioning

confidence: 99%

Human infection withStrongyloides stercoralisand other related Strongyloides species

2016

View full text Add to dashboard Cite

SUMMARY The majority of the 30–100 million people infected with Strongyloides stercoralis, a soil transmitted intestinal nematode, have subclinical (or asymptomatic) infections. These infections are commonly chronic and longstanding because of the autoinfective process associated with its unique life cycle. A change in immune status can increase parasite numbers, leading to hyperinfection syndrome, dissemination, and death if unrecognized. Corticosteroid use and HTLV-1 infection are most commonly associated with the hyperinfection syndrome. Strongyloides adult parasites reside in the small intestine and induce immune responses both local and systemic that remain poorly characterized. Definitive diagnosis of S. stercoralis infection is based on stool examinations for larvae, but newer diagnostics – including new immunoassays and molecular tests – will assume primacy in the next few years. Although good treatment options exist for infection and control of this infection might be possible, S. stercoralis remains largely neglected.

show abstract

Periumbilical parasitic thumbprint purpura: Strongyloides hyperinfection syndrome acquired from a cadaveric renal transplant

Cited by 45 publications

References 25 publications

Strongyloides stercoralis Transmission by Kidney Transplantation in Two Recipients From a Common Donor

Strongyloides stercoralis Transmission by Kidney Transplantation in Two Recipients From a Common Donor

Update on Strongyloidiasis in the Immunocompromised Host

Human infection withStrongyloides stercoralisand other related Strongyloides species

Contact Info

Product

Resources

About