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Case report: strongyloidiasis refractory to treatment with ivermectin
M Ashraf1, C L Gue, L M Baddour
1Department of Medicine, University of Tennessee Medical Center, Knoxville, USA.
The American Journal of the Medical Sciences
|April 1, 1996
Summary
Ivermectin is effective for disseminated Strongyloides stercoralis infections. However, this case shows ivermectin failure in a hypogammaglobulinemia patient, highlighting treatment challenges.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Immunology
Background:
- Strongyloides stercoralis causes asymptomatic infections but can disseminate in immunocompromised individuals.
- Disseminated infections have high mortality and thiabendazole often fails; ivermectin shows promise.
- Hypogammaglobulinemia is an underrecognized risk factor for severe parasitic infections.
Observation:
- A patient with hypogammaglobulinemia presented with strongyloidiasis.
- Despite multiple treatment courses over 14 months, ivermectin failed to eradicate Strongyloides larvae from stool.
Findings:
- This case demonstrates ivermectin treatment failure in a patient with hypogammaglobulinemia.
- Persistent Strongyloides larvae indicate a potential lack of efficacy in specific immune-deficient states.
Implications:
- Ivermectin may not be universally effective for disseminated strongyloidiasis, particularly in hypogammaglobulinemia.
- Alternative or adjunctive therapies should be considered for such patients.
- Further research is needed to understand treatment resistance in Strongyloides infections.