Recurrent Streptococcus bovis Meningitis in Strongyloides stercoralis Hyperinfection after Kidney Transplantation: The Dilemma in a Non-Endemic Area

Khan, Tasnim; Elzein, Fatehi; Fiaar, Abdullah; Akhtar, Faheem

doi:10.4269/ajtmh.13-0494

Cited by 13 publications

(12 citation statements)

References 18 publications

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“…Two cases reported in Riyadh were of Saudi adult post–kidney transplant recipients who were ultimately diagnosed with S. Stercoralis hyperinfection. In one case, the patient had presented with recurrent Streptococcus bovis meningitis followed by E. coli chest infection, and in the other case, the patient had recurrent E. Coli urosepsis and CMV reactivation . These cases highlight the risk of morbidity associated with migrating larvae.…”

Section: Discussionmentioning

confidence: 98%

“…Ivermectin is not currently approved by the SFDA and is not available as a treatment option . Most case reports from Saudi Arabia document treatment with albendazole . Albendazole has an efficacy of 45%‐75% and is considered a second‐line agent .…”

Section: Discussionmentioning

confidence: 99%

“…In one case, the patient had presented with recurrent Streptococcus bovis meningitis followed by E. coli chest infection, and in the other case, the patient had recurrent E. Coli urosepsis and CMV reactivation. 15,16 These cases highlight the risk of morbidity associated with migrating larvae. Regionally, in the Middle East, three fatal cases of Strongyloides hyperinfection post-kidney transplant have been reported from Kuwait.…”

Section: Discussionmentioning

confidence: 99%

“…28 Most case reports from Saudi Arabia document treatment with albendazole. 12,13,15 Albendazole has an efficacy of 45%-75% and is considered a second-line agent. 29 The recommended dose is 400 mg orally twice a day for 7 days, although treatment durations in reported cases are varied.…”

Section: Kidney Transplantation Began In Saudi Arabia With Living-relmentioning

confidence: 99%

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Donor‐derived strongyloidiasis in a Saudi pediatric kidney transplant recipient: A case report and mini‐review

Alsager

Waqar

Furrukh

et al. 2018

Pediatric Transplantation

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S. stercoralis infection has been identified as a donor‐derived infection in cases of solid organ transplant among recipients with no prior risk factor for parasitic exposure. Worldwide and regional reports from the adult kidney transplant population highlight this indirect method of infection and caution about delayed diagnosis, severe complications, and death related to donor‐derived S. stercoralis infection. We report a deceased‐donor‐derived S. stercoralis infection in a 12‐year‐old Saudi girl who underwent kidney transplantation. This is the first pediatric case reported outside the United States of America. Although she presented with mild bouts of gastrointestinal symptoms, the need for additional immune suppression put her at risk of serious complications. A literature review highlights the importance of awareness about S. stercoralis infections and complications in kidney transplant recipients, pretransplant screening of donors based on risk assessment, and the challenges with treatment availability and duration in this vulnerable population.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Kidney Transplantation Began In Saudi Arabia With Living-relmentioning

confidence: 99%

See 2 more Smart Citations

Donor‐derived strongyloidiasis in a Saudi pediatric kidney transplant recipient: A case report and mini‐review

Alsager

Waqar

Furrukh

et al. 2018

Pediatric Transplantation

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“…Recurrent episodes of bacterial meningitis in patients with strongyloidiasis are reported in subjects presenting predisposing factors, such as organ transplant, 13 corticosteroid use, 14 diabetes, 14 and HTLV-1 infection. 15 …”

Section: Discussionmentioning

confidence: 99%

Persistent Strongyloidiasis Complicated by Recurrent Meningitis in an HTLV Seropositive Peruvian Migrant Resettled in Italy

Zammarchi¹,

Montagnani²,

Tordini³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. We describe a case of persistent strongyloidiasis complicated by recurrent meningitis, in a human T cell lymphotropic virus type 1 (HTLV-1) seropositive Peruvian migrant adult resettled in Italy. He was admitted with signs and symptoms of acute bacterial meningitis, reporting four other meningitis episodes in the past 6 years, with an etiological diagnosis of Escherichia coli and Enterococcus faecium in two cases. He had been previously treated with several antihelmintic regimens not including ivermectin, without eradication of strongyloidiasis, and he had never been tested for HTLV before. During the described episode, the patient was treated for meningitis with broad-spectrum antibiotic therapy and 200 μg/kg/dose oral ivermectin once daily on day 1, 2, 15 and 16 with full recovery and no further episodes of meningitis. The presented case underlines several critical points concerning the management of poorly known neglected diseases such as strongyloidiasis and HTLV infection in low-endemic areas. Despite several admissions for meningitis and strongyloidiasis, the parasitic infection was not adequately treated and the patient was not previously tested for HTLV. The supply of ivermectin and the choice of treatment scheme was challenging since ivermectin is not approved in Italy and there are no standardized guidelines for the treatment of severe strongyloidiasis in HTLV seropositive subjects.

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Strongyloides stercoralis Infection in Solid Organ Transplant Recipients: a Case-Cohort Report at a Single-Center Experience

et al. 2019

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Recurrent Streptococcus bovis Meningitis in Strongyloides stercoralis Hyperinfection after Kidney Transplantation: The Dilemma in a Non-Endemic Area

Cited by 13 publications

References 18 publications

Donor‐derived strongyloidiasis in a Saudi pediatric kidney transplant recipient: A case report and mini‐review

Donor‐derived strongyloidiasis in a Saudi pediatric kidney transplant recipient: A case report and mini‐review

Persistent Strongyloidiasis Complicated by Recurrent Meningitis in an HTLV Seropositive Peruvian Migrant Resettled in Italy

Strongyloides stercoralis Infection in Solid Organ Transplant Recipients: a Case-Cohort Report at a Single-Center Experience

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