Opportunistic Strongyloidiasis in Renal Transplant Reciepients

Morgan, James S.; Schaffner, William; Stone, William J.

doi:10.1097/00007890-198611000-00016

Cited by 79 publications

(68 citation statements)

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“…The majority of cases of hyperinfection that have occurred following organ transplant have occurred following renal transplant, and most of these cases seem to have been precipitated by increased glucocorticoid doses in response to rejection (9,18,27,50,58,74,87,116,125,129,131). The lack of reported cases following heart, lung, and liver transplants may simply reflect the fewer patients from Strongyloides-endemic areas receiving these transplants.…”

Section: Kidney Transplantsmentioning

confidence: 99%

Strongyloides stercoralisin the Immunocompromised Population

2004

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Strongyloides stercoralis is an intestinal nematode of humans that infects tens of millions of people worldwide. S. stercoralis is unique among intestinal nematodes in its ability to complete its life cycle within the host through an asexual autoinfective cycle, allowing the infection to persist in the host indefinitely. Under some conditions associated with immunocompromise, this autoinfective cycle can become amplified into a potentially fatal hyperinfection syndrome, characterized by increased numbers of infective filariform larvae in stool and sputum and clinical manifestations of the increased parasite burden and migration, such as gastrointestinal bleeding and respiratory distress. S. stercoralis hyperinfection is often accompanied by sepsis or meningitis with enteric organisms. Glucocorticoid treatment and human T-lymphotropic virus type 1 infection are the two conditions most specifically associated with triggering hyperinfection, but cases have been reported in association with hematologic malignancy, malnutrition, and AIDS. Anthelmintic agents such as ivermectin have been used successfully in treating the hyperinfection syndrome as well as for primary and secondary prevention of hyperinfection in patients whose exposure history and underlying condition put them at increased risk

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Section: Kidney Transplantsmentioning

confidence: 99%

Strongyloides stercoralisin the Immunocompromised Population

2004

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“…17 The most severe effects of Strongyloides infections occur in patients receiving immunosuppressive therapy with corticosteroids. [18][19][20][21] In these patients, the immune system is no longer able to keep the larvae emerging from the autoinfective cycle under control, resulting in hyperinfection affecting the proper functioning of the gastrointestinal tract or the dissemination of larvae to multiple organs including the brain. Such massive infections may lead to life-threatening conditions with pneumonia, meningitis, septicaemia and intestinal obstruction.…”

Section: Morbidity Caused By Strongyloidesmentioning

confidence: 99%

Strongyloidiasis – the most neglected of the neglected tropical diseases?

Olsen

Lieshout

Marti

et al. 2009

Transactions of the Royal Society of Tropical Medicine and Hygi

494

448

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a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : h t t p : / / w w w . e l s e v i e r . c o m / l o c a t e / t r s t m h Summary Soil-transmitted helminths of the genus Strongyloides (S. fuelleborni and the more prevalent S. stercoralis) are currently believed to infect an estimated 30-100 million people worldwide. The health consequences of S. stercoralis infections range from asymptomatic light infections to chronic symptomatic strongyloidiasis. Uncontrolled multiplication of the parasite (hyperinfection) and potentially life-threatening dissemination of larvae to all internal organs is found among individuals with compromised immune system functions. This paper provides an overview of the current state of the art in relation to diagnostic methods for detecting the infection, the morbidity caused by the infection and the recommended treatment. It further discusses some of the reasons why this infection is so neglected and the consequence of this for the estimated global prevalence. The paper finally points to the gaps in our knowledge and future research needs related to this infection. As Strongyloides infections have the potential to develop into severe disease in certain population subgroups, untreated infections could cause serious problems in the community. Therefore, we need to carefully investigate this parasite in order to develop and implement effective control programmes. REVIEW Strongyloidiasis

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“…Various cases in renal and heart transplant recipients and, more recently, following pancreatic transplantation have been reported. In the majority of cases, symptoms of strongyloidiasis developed in the first 6 months following transplantation (103,257,351).…”

Section: Infections Caused By Strongyloides Stercoralismentioning

confidence: 99%

“…Another situation that has been well described in transplant patients, not related to transmission via the organ but related to prior infection of the recipient, is hyperinfestation syndrome (113,187,247,257,284,325,379,381,398). This is due to an accelerated autoinfection cycle almost always associated with immune suppression (especially suppression of T-lymphocyte activity).…”

Section: Infections Caused By Strongyloides Stercoralismentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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SUMMARY In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

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Opportunistic Strongyloidiasis in Renal Transplant Reciepients

Cited by 79 publications

References 0 publications

Strongyloides stercoralisin the Immunocompromised Population

Strongyloides stercoralisin the Immunocompromised Population

Strongyloidiasis – the most neglected of the neglected tropical diseases?

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

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