Fatal Multiorgan Failure Syndrome in a Strongyloides-HTLV-1 Coinfected Patient, after Treatment with Ivermectin

Because of its characteristic features of autoinfection, the parasitic nematode Strongyloides stercoralis can infect patients for years. An acceleration of its autoinfective cycle can be triggered by human T-lymphotropic virus-1 (HTLV-1) infection, mainly by the deviation of the protective Th2- to T...

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Main Authors: Emmanuelle Guérin, Paule Poirier, Marine Nervo, Christophe Le Terrier
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2021/5554810
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author Emmanuelle Guérin
Paule Poirier
Marine Nervo
Christophe Le Terrier
author_facet Emmanuelle Guérin
Paule Poirier
Marine Nervo
Christophe Le Terrier
author_sort Emmanuelle Guérin
collection DOAJ
description Because of its characteristic features of autoinfection, the parasitic nematode Strongyloides stercoralis can infect patients for years. An acceleration of its autoinfective cycle can be triggered by human T-lymphotropic virus-1 (HTLV-1) infection, mainly by the deviation of the protective Th2- to Th1-type immune response and can lead to severe disease by dissemination of Strongyloides stercoralis larvae carrying intestinal bacteria to multiple organs. Meningitis caused by enteric Gram-negative bacteria is a potentially fatal complication of disseminated strongyloidiasis. Herein, we present the case of a Strongyloides-HTLV-1 coinfected patient, admitted for E. coli meningitis. One day after initiation of ivermectin, the patient developed significant S. stercoralis dissemination, complicated by multiorgan failure syndrome, and died from neurological failure. While the initial clinical scenario of our case has already been well described in the literature, its course after antihelminthic treatment initiation remains unclear and needs to be discussed.
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institution Kabale University
issn 2090-6420
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spelling doaj-art-dee8dee29931435a8cdf340d778d40ef2025-08-20T03:26:15ZengWileyCase Reports in Critical Care2090-64202090-64392021-01-01202110.1155/2021/55548105554810Fatal Multiorgan Failure Syndrome in a Strongyloides-HTLV-1 Coinfected Patient, after Treatment with IvermectinEmmanuelle Guérin0Paule Poirier1Marine Nervo2Christophe Le Terrier3Intensive Care Unit, University Hospital of Martinique, Fort-de-France, FranceIntensive Care Unit, University Hospital of Martinique, Fort-de-France, FranceDepartment of Pathology, Saint-Louis University Hospital, AP-HP, Paris University, Paris, FranceIntensive Care Unit, University Hospitals of Geneva, Geneva, SwitzerlandBecause of its characteristic features of autoinfection, the parasitic nematode Strongyloides stercoralis can infect patients for years. An acceleration of its autoinfective cycle can be triggered by human T-lymphotropic virus-1 (HTLV-1) infection, mainly by the deviation of the protective Th2- to Th1-type immune response and can lead to severe disease by dissemination of Strongyloides stercoralis larvae carrying intestinal bacteria to multiple organs. Meningitis caused by enteric Gram-negative bacteria is a potentially fatal complication of disseminated strongyloidiasis. Herein, we present the case of a Strongyloides-HTLV-1 coinfected patient, admitted for E. coli meningitis. One day after initiation of ivermectin, the patient developed significant S. stercoralis dissemination, complicated by multiorgan failure syndrome, and died from neurological failure. While the initial clinical scenario of our case has already been well described in the literature, its course after antihelminthic treatment initiation remains unclear and needs to be discussed.http://dx.doi.org/10.1155/2021/5554810
spellingShingle Emmanuelle Guérin
Paule Poirier
Marine Nervo
Christophe Le Terrier
Fatal Multiorgan Failure Syndrome in a Strongyloides-HTLV-1 Coinfected Patient, after Treatment with Ivermectin
Case Reports in Critical Care
title Fatal Multiorgan Failure Syndrome in a Strongyloides-HTLV-1 Coinfected Patient, after Treatment with Ivermectin
title_full Fatal Multiorgan Failure Syndrome in a Strongyloides-HTLV-1 Coinfected Patient, after Treatment with Ivermectin
title_fullStr Fatal Multiorgan Failure Syndrome in a Strongyloides-HTLV-1 Coinfected Patient, after Treatment with Ivermectin
title_full_unstemmed Fatal Multiorgan Failure Syndrome in a Strongyloides-HTLV-1 Coinfected Patient, after Treatment with Ivermectin
title_short Fatal Multiorgan Failure Syndrome in a Strongyloides-HTLV-1 Coinfected Patient, after Treatment with Ivermectin
title_sort fatal multiorgan failure syndrome in a strongyloides htlv 1 coinfected patient after treatment with ivermectin
url http://dx.doi.org/10.1155/2021/5554810
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