BACKGROUND: Infection is the most frequent complication after heart transplantation (HTx). In this report and brief literature review we present a recipient who some 6 weeks post-HTx had two donor-related infections: a "common" primary cytomegalovirus (CMV) infection and, simultaneously, a highly unusual donor-related Strongyloides stercoralis infection. METHODS: The parasite was discovered by chance in a skin biopsy. CMV was treated with ganciclovir and the strongyloidiasis was cured with two courses of anti-helminthic therapy--initially with ivermectine and albendazol and, in response to eosinophilia, with ivermectine monotherapy. The patient's recovery was further complicated by two successive rejection episodes, a relapse of the CMV syndrome and a novel influenza A/H1N1 infection. These episodes were treated with steroids, ganciclovir and oseltamivir, respectively. RESULTS: It took almost 9 months before a permanent IgG anti-CMV response was seen. At 13 months post-HTx, coronary angiography showed only slight vessel wall abnormalities. At present, the patient is back at home and in good condition. CONCLUSION: Until now, only 4 recipient-derived strongyloidiasis cases have been described in post-HTx patients, all diagnosed by autopsies. This is the first report of a donor-related Strongyloides infection in a patient after HTx.
BACKGROUND:Infection is the most frequent complication after heart transplantation (HTx). In this report and brief literature review we present a recipient who some 6 weeks post-HTx had two donor-related infections: a "common" primary cytomegalovirus (CMV) infection and, simultaneously, a highly unusual donor-related Strongyloides stercoralis infection. METHODS: The parasite was discovered by chance in a skin biopsy. CMV was treated with ganciclovir and the strongyloidiasis was cured with two courses of anti-helminthic therapy--initially with ivermectine and albendazol and, in response to eosinophilia, with ivermectine monotherapy. The patient's recovery was further complicated by two successive rejection episodes, a relapse of the CMV syndrome and a novel influenza A/H1N1infection. These episodes were treated with steroids, ganciclovir and oseltamivir, respectively. RESULTS: It took almost 9 months before a permanent IgG anti-CMV response was seen. At 13 months post-HTx, coronary angiography showed only slight vessel wall abnormalities. At present, the patient is back at home and in good condition. CONCLUSION: Until now, only 4 recipient-derived strongyloidiasis cases have been described in post-HTxpatients, all diagnosed by autopsies. This is the first report of a donor-related Strongyloides infection in a patient after HTx.
Authors: Dora Buonfrate; Ana Requena-Mendez; Andrea Angheben; Jose Muñoz; Federico Gobbi; Jef Van Den Ende; Zeno Bisoffi Journal: BMC Infect Dis Date: 2013-02-08 Impact factor: 3.090
Authors: Bhalaghuru Chokkalingam Mani; Moses Mathur; Heather Clauss; Rene Alvarez; Eman Hamad; Yoshiya Toyoda; Mark Birkenbach; Mustafa Ahmed Journal: Case Rep Transplant Date: 2013-05-27