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Disseminated strongyloidiasis in a child with lymphoblastic lymphoma
J D Daubenton1, H A Buys, P S Hartley
1Department of Paediatrics and Child Health, University of Cape Town, Red Cross War Memorial Children's Hospital, South Africa.
Insights
Disseminated strongyloidiasis is a severe complication in children with T-cell lymphoblastic lymphoma undergoing chemotherapy. Early screening and treatment with ivermectin are crucial for preventing life-threatening outcomes.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Immunology
Background:
- Disseminated strongyloidiasis is a potentially fatal complication of Strongyloides stercoralis infection.
- Patients undergoing immunosuppressive therapy, especially with corticosteroids, are at increased risk.
- T-cell lymphoblastic lymphoma treatment often involves intensive immunosuppression.
Observation:
- A 10-year-old boy developed severe disseminated strongyloidiasis during chemotherapy for T-cell lymphoblastic lymphoma.
- The patient presented with symptoms four weeks after initiating treatment.
- Initial treatment included supportive care, antibiotics, and albendazole.
Findings:
- The patient required ivermectin to successfully eradicate the Strongyloides infection.
- Albendazole alone was insufficient for complete parasite clearance.
- Ivermectin demonstrated efficacy in resolving disseminated strongyloidiasis in this immunocompromised child.
Implications:
- Screening for Strongyloides stercoralis in endemic areas before initiating immunosuppressive therapy is vital.
- Prompt and appropriate antiparasitic treatment, particularly with ivermectin, can be life-saving.
- This case highlights the importance of considering strongyloidiasis in immunocompromised pediatric patients presenting with severe illness.
Purpose:
This report describes a case of disseminated strongyloidiasis in a child receiving chemotherapy for T-cell lymphoblastic lymphoma.
Patient And Methods:
A 10-year-old boy became severely ill with disseminated strongyloidiasis 4 weeks after starting chemotherapy for T-cell lymphoblastic lymphoma. He responded to treatment with supportive care, antibiotics, and albendazole but required ivermectin to eradicate the strongyloides infection.
Conclusion:
Disseminated strongyloidiasis is a severe, life-threatening complication of Strongyloides stercoralis infection that can occur in patients on immunosuppressive therapy, particularly when this therapy includes corticosteriods. In endemic areas, screening patients due to undergo immunosuppressive treatment and appropriate antistrongyloides treatment may be life saving. Ivermectin is the treatment of choice.