Strongyloides and hookworms co-infection in a liver transplant patient

We here present a female patient who is a recipient of liver transplantation from a cadaveric donor. She developed abdominal pain, nausea, vomiting, and diarrhea for two weeks of duration, after four months of the transplant. Upper gastrointestinal (GI) endoscopy and stool analysis for ova and parasite showed Necator americanus / Ancylostoma duodenale (Hookworm) ova /larvae and Strongyloides stercoralis Larvae. She had a dramatic clinical response to Ivermectin and Albendazole combination, which was given until the clearance of her stool exam. She was discharged from the hospital in good condition, and her infection is considered as a donor-derived transmission of these parasites. To the best of our knowledge, this is the first case report of Strongyloides stercoralis and hookworm co-infection in a liver transplant patient. Parasitic infection should be considered in the differential diagnosis of diarrheal illness of cadaveric transplant patients, even if it is not prevalent in the region.