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Strongyloides stercoarlis--hyperinfection.

W P Boyd, F W Campbell, W L Trudeau

    The American Journal of Tropical Medicine and Hygiene
    |January 1, 1978
    PubMed
    Summary
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    Severe Strongyloides stercoralis infection in a patient with renal failure was treated with mebendazole. Mebendazole proved effective, demonstrating a viable alternative therapy when the primary drug is contraindicated due to kidney dysfunction.

    Area of Science:

    • Nephrology
    • Infectious Diseases
    • Pharmacology

    Background:

    • Strongyloides stercoralis infection (strongyloidiasis) poses significant risks, especially in immunocompromised individuals or those with chronic conditions.
    • Renal failure, particularly bilateral cortical necrosis, complicates treatment options for parasitic infections due to altered drug pharmacokinetics.

    Observation:

    • A severe case of Strongyloides stercoralis infection occurred in a patient with end-stage renal disease secondary to bilateral cortical necrosis.
    • The standard treatment, thiabendazole, is renally excreted and thus contraindicated in this patient population.

    Findings:

    • Alternative therapy with mebendazole was initiated for the strongyloidiasis.
    • Despite the patient's fatal outcome from renal failure, the efficacy of mebendazole in treating Strongyloides stercoralis infection was successfully demonstrated.

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    Implications:

    • Mebendazole represents a potential therapeutic alternative for strongyloidiasis in patients with severe renal impairment.
    • This case highlights the importance of considering drug metabolism and excretion pathways in patients with renal failure when selecting antiparasitic agents.
    • Further research into the use of mebendazole in renal insufficiency for strongyloidiasis is warranted.