Strongyloides hyperinfection following hematopoietic stem cell transplant in a patient with HTLV-1-associated T-cell leukemia

Jonathan D Alpern; Sophie S Arbefeville; Gregory Vercellotti; Patricia Ferrieri; Jaime S Green

doi:10.1111/tid.12638

Strongyloides hyperinfection following hematopoietic stem cell transplant in a patient with HTLV-1-associated T-cell leukemia

Transpl Infect Dis. 2017 Feb;19(1). doi: 10.1111/tid.12638. Epub 2017 Jan 6.

Authors

Jonathan D Alpern¹, Sophie S Arbefeville², Gregory Vercellotti³, Patricia Ferrieri^{2

4}, Jaime S Green¹

Affiliations

¹ Division of Infectious Disease & International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
² Infectious Diseases Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.
³ Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
⁴ Division of Infectious Diseases, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.

PMID: 27860061
DOI: 10.1111/tid.12638

Abstract

Strongyloides stercoralis has the potential to cause accelerated autoinfection in immunocompromised hosts. Screening tests for strongyloidiasis may be falsely negative in the setting of immunosuppression. We report a case of Strongyloides hyperinfection syndrome in a patient with human T-lymphotropic virus type 1-associated T-cell leukemia early after hematopoietic stem cell transplant. The diagnosis was made by stool ova and parasite examination, despite a negative screening enzyme-linked immunosorbent assay. Because of anticipated prolonged neutropenia, an extended course of treatment was utilized.

Keywords: HTLV-1; Strongyloides hyperinfection syndrome; human T-lymphotropic virus type 1; strongyloidiasis.

Publication types

Case Reports

MeSH terms

Adult
Animals
Antineoplastic Agents / therapeutic use
Antiprotozoal Agents / therapeutic use
Enzyme-Linked Immunosorbent Assay
Fatal Outcome
HTLV-I Infections / complications*
HTLV-I Infections / therapy
HTLV-I Infections / virology
Hematopoietic Stem Cell Transplantation / adverse effects*
Hepatitis B, Chronic / complications
Human T-lymphotropic virus 1 / isolation & purification*
Humans
Immunocompromised Host
Leukemia, T-Cell / complications*
Leukemia, T-Cell / therapy
Leukemia, T-Cell / virology
Lymphoma, T-Cell / complications*
Lymphoma, T-Cell / therapy
Lymphoma, T-Cell / virology
Male
Respiratory Distress Syndrome / complications
Respiratory Insufficiency / etiology
Strongyloides stercoralis / isolation & purification*
Strongyloidiasis / diagnosis*
Strongyloidiasis / drug therapy
Strongyloidiasis / parasitology
Transplantation Conditioning / adverse effects*
Transplantation Conditioning / methods

Substances

Antineoplastic Agents
Antiprotozoal Agents