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Massive Airway Bleeding Caused by Pulmonary Strongyloidiasis in a Patient with a Transplanted Kidney
Longyin Zhu1, Huhai Zhang1, Jia Fang1
1Department of Nephrology, the First Hospital Affiliated to Army Military Medical University (Southwest Hospital), Chongqing, 400038, People's Republic of China.
Introduction:
We report a fatal case of massive airway bleeding caused by pulmonary strongyloidiasis in a patient with a transplanted kidney.
Case Presentation:
A 47-year-old male, regularly taking immunosuppressants post-kidney transplant, visited our hospital with symptoms of abdominal bloating, nausea, and emesis persisting for three days. After hospitalization, he developed a cough, hemoptysis, and respiratory failure. Sputum analysis confirmed an infestation with Strongyloides stercoralis. Despite receiving albendazole therapy and bronchoscopic management for bronchial hemorrhage, the patient ultimately died due to acute respiratory and circulatory collapse triggered by severe airway bleeding.
Conclusion:
Patients undergoing immunosuppressive therapy following kidney transplantation are at increased risk for disseminated strongyloidiasis. Consequently, infectious disease screening prior to transplantation, along with essential preventive pharmacotherapy, is of paramount importance.
Insights
A kidney transplant recipient died from severe airway bleeding due to pulmonary strongyloidiasis. Immunosuppressed patients require diligent screening for Strongyloides to prevent fatal disseminated infections.
Area of Science:
- Medical Mycology
- Transplant Immunology
- Pulmonary Medicine
Background:
- Kidney transplant recipients on immunosuppressants face heightened risks of opportunistic infections.
- Disseminated strongyloidiasis is a severe complication in immunocompromised individuals.
Observation:
- A 47-year-old male, post-kidney transplant and on immunosuppressants, presented with gastrointestinal symptoms.
- He rapidly developed hemoptysis, cough, and respiratory failure.
- Sputum analysis confirmed Strongyloides stercoralis infestation.
Findings:
- The patient experienced massive airway bleeding secondary to pulmonary strongyloidiasis.
- Despite albendazole treatment and bronchoscopic intervention, he succumbed to acute respiratory and circulatory collapse.
Implications:
- This case underscores the critical need for pre-transplant infectious disease screening, particularly for Strongyloides.
- Prophylactic pharmacotherapy is essential to mitigate the risk of disseminated strongyloidiasis in transplant candidates.
- Early detection and management are vital for improving outcomes in immunocompromised patients with parasitic infections.
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