Article

Disseminated Strongyloides stercoralis Infection in HTLV-1-Associated Adult T-Cell Leukemia/Lymphoma

Metabolism Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Acta Haematologica (Impact Factor: 0.99). 04/2011; 126(2):63-7. DOI: 10.1159/000324799
Source: PubMed

ABSTRACT A 55-year-old woman with human T-cell lymphotropic virus type-1 (HTLV-1)-associated adult T-cell leukemia (ATL) and a history of previously treated Strongyloides stercoralis infection received anti-CD52 monoclonal antibody therapy with alemtuzumab on a clinical trial. After an initial response, she developed ocular involvement by ATL. Alemtuzumab was stopped and high-dose corticosteroid therapy was started to palliate her ocular symptoms. Ten days later, the patient developed diarrhea, vomiting, fever, cough, skin rash, and a deteriorating mental status. She was diagnosed with disseminated S. stercoralis. Corticosteroids were discontinued and the patient received anthelmintic therapy with ivermectin and albendazole with complete clinical recovery.

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    • "Our patient's previous occupation as an army staff had probably exposed him to an asymptomatic and lifelong chronic strongyloidiasis before the immunosuppression episodes caused by hematological cancer, chemotherapy and steroid treatment. Thus screening of high risk individuals or empiric anti-helminth treatment in suspected patients with or without eosinophilia is warranted prior to immunosuppression to prevent the severe morbidity and mortality associated with hyperinfection syndrome [7] [22] [24] [25] Once diagnosed, strongyloidiasis warrants treatment particularly among the high risk patients. A combination therapy of albendazole (oral, 400 mg twice daily) for 7 days and ivermectin (oral, 200 μg/kg daily) for 1–2 days is recommended for the treatment in immunosuppressed patients [9]. "
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    • "Our patient's previous occupation as an army staff had probably exposed him to an asymptomatic and lifelong chronic strongyloidiasis before the immunosuppression episodes caused by hematological cancer, chemotherapy and steroid treatment. Thus screening of high risk individuals or empiric anti-helminth treatment in suspected patients with or without eosinophilia is warranted prior to immunosuppression to prevent the severe morbidity and mortality associated with hyperinfection syndrome [7] [22] [24] [25] Once diagnosed, strongyloidiasis warrants treatment particularly among the high risk patients. A combination therapy of albendazole (oral, 400 mg twice daily) for 7 days and ivermectin (oral, 200 μg/kg daily) for 1–2 days is recommended for the treatment in immunosuppressed patients [9]. "
    Dataset: zueter
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    • "Our patient's previous occupation as an army staff had probably exposed him to an asymptomatic and lifelong chronic strongyloidiasis before the immunosuppression episodes caused by hematological cancer, chemotherapy and steroid treatment. Thus screening of high risk individuals or empiric anti-helminth treatment in suspected patients with or without eosinophilia is warranted prior to immunosuppression to prevent the severe morbidity and mortality associated with hyperinfection syndrome [7] [22] [24] [25] Once diagnosed, strongyloidiasis warrants treatment particularly among the high risk patients. A combination therapy of albendazole (oral, 400 mg twice daily) for 7 days and ivermectin (oral, 200 μg/kg daily) for 1–2 days is recommended for the treatment in immunosuppressed patients [9]. "
    Dataset: AbdelRahman
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