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Int J Antimicrob Agents. 2013 Dec;42(6):580-3. doi: 10.1016/j.ijantimicag.2013.07.015. Epub 2013 Sep 7.

Strongyloides disseminated infection successfully treated with parenteral ivermectin: case report with drug concentration measurements and review of the literature.

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  • 1Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Abstract

We report the case of an immunosuppressed patient with Strongyloides disseminated infection who was successfully treated with the veterinary parenteral form of ivermectin. A kidney transplant recipient developed disseminated infection with Strongyloides stercoralis. Because oral treatment with ivermectin was not possible, subcutaneous ivermectin (75 µg/kg/day, then 200 µg/kg/day) was given for 9 days, with clinical improvement and disappearance of all larvae. Serum ivermectin concentrations were between 15.6 ng/mL and 19.7 ng/mL during the 9 days of therapy; however, drug accumulation (plasma levels >40 ng/mL) 48 h after discontinuation of therapy was associated with the development with encephalopathy. We also review all cases of human disseminated Strongyloides infection treated with parenteral ivermectin.

Copyright © 2013 Elsevier B.V. and the International Society of Chemotherapy. Published by Elsevier B.V. All rights reserved.

KEYWORDS:

Disseminated infection; Hyperinfection; Ivermectin; Serum concentration; Strongyloides stercoralis

PMID:
24269075
[PubMed - indexed for MEDLINE]
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