Strongyloides stercoralis hyperinfection in hematopoietic stem cell transplantation

Authors: Wirk, B.; Wingard, J.R.

Source: Transplant Infectious Disease, Volume 11, Number 2, April 2009 , pp. 143-148(6)

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Abstract:

B. Wirk, J.R. Wingard. Strongyloides stercoralis hyperinfection in hematopoietic stem cell transplantation.

Strongyloides stercoralis is endemic in tropical, subtropical, and even temperate regions, and infects up to 100 million people worldwide. The diagnosis of strongyloidiasis can be difficult because of intermittent larval output in stool and nonspecific symptoms with mild peripheral eosinophilia. In this case report, a patient with acute myelogenous leukemia underwent peripheral blood hematopoietic stem cell transplantation (HSCT) and was subsequently diagnosed with strongyloidiasis. Strongyloidiasis should be considered in immunocompromised patients from endemic areas who have unexplained peripheral eosinophilia. If screening tests are positive for S. stercoralis or if a patient has unexplained eosinophilia with even a remote history of travel to or residence in endemic areas, then ivermectin should be given before HSCT to prevent often fatal hyperinfection syndrome from occurring after HSCT.

Keywords: Strongyloides stercoralis; hematopoietic stem cell transplantation; hyperinfection; invermectin

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1399-3062.2008.00360.x

Affiliations: 1: Bone Marrow Transplant Program, Division of Hematology-Oncology, University of Florida College of Medicine, Gainesville, Florida, USA

Publication date: 2009-04-01