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[Strongyloidiasis following kidney transplantation]
Schweizerische Medizinische Wochenschrift
|October 21, 1978
Summary
A renal transplant recipient developed fatal strongyloidiasis, a parasitic infection, weeks after surgery. Disseminated Strongloides stercoralis larvae caused severe pneumonia and septic shock, highlighting risks in immunocompromised patients.
Area of Science:
- Medical Microbiology
- Transplant Immunology
- Parasitology
Context:
- A 50-year-old male with a history of malaria, tuberculosis, and chronic kidney disease underwent renal allotransplantation.
- The patient experienced a mild acute rejection crisis post-transplantation, successfully treated.
- Pre-existing conditions included hypertension, proteinuria, and unexplained eosinophilia, necessitating dialysis prior to transplant.
Purpose:
- To report a fatal case of disseminated strongyloidiasis in a renal transplant recipient.
- To investigate the pathological findings and clinical course of Strongloides stercoralis infection post-immunosuppression.
- To emphasize the potential for severe parasitic infections in immunocompromised individuals.
Summary:
- The patient developed bilateral pneumonia eight weeks post-renal allotransplantation, unresponsive to extensive treatment.
- Autopsy revealed disseminated Strongloides stercoralis infection, with larvae found in the intestines, lungs, brain, arteries, and lymph nodes.
- Massive granulomatous inflammation and pulmonary hemorrhage were the primary pathological findings, leading to septic shock and death.
Impact:
- This case underscores the critical need for screening and vigilance for parasitic infections, particularly Strongloides stercoralis, in renal transplant candidates and recipients.
- Highlights the risk of hyperinfection syndrome in immunocompromised patients, even with a history of latent infection.
- Informs clinical practice regarding the management of infections in post-transplant patients and the importance of considering parasitic etiologies.