Chandana H1*, Mallawarachchi2, Chandrasena3 and Gunawardena3
1Department of Medical Microbiology, Medical Research Institution, Sri Lanka 2Ministry of Health, Sri Lanka 3Department of Parasitology, University of Kelaniya, Sri LankaFulltext PDF
Strongyloidiasis caused by Strongyloides stercoralis is a Soil-Transmitted Helminth infection (STH) which is one of the most overlooked of helminthiases. S. stercoralis is an exception among other STHs as it can reproduce within the human host (autoinfection) causing long-standing chronic infections. Chronic low-intensity infections may remain asymptomatic. However, it can cause severe life-threatening conditions referred to as Strongyloides Hyperinfection Syndrome (SHS) and disseminated strongyloidiasis due to reactivation in immune compromised patients. In this case, a recipient who had undergone cadaveric renal transplant was found positive for strongyloidiasis approximately one year after the transplantation. Though there was evidence suggestive of strongyloidiasis in the pre-transplant and post-transplant phases; high blood eosinophilia and intermittent gastrointestinal symptoms with skin lesions respectively, these pointers were missed on multiple occasions leading to delays in further investigations. Immunocompromised states could facilitate autoinfection causing SHS and disseminated strongyloidiasis. In a transplant recipient, infection could be due to reactivation of chronic infection or donor derived infection or a primary acquired infection during the post-transplant phase. In the current case-scenario all three modes of infections were possible. Proper screening of recipients and donors with high eosinophil counts for potential infections before transplantation is essential. The screening could be done coprological over several days and/ or serologically.
Strongyloides stercoralis; Immune compromised; Soil-transmitted infection; Postrenal transplant
Chandana H, Mallawarachchi, Chandrasena, Gunawardena. Strongyloidiasis in Kidney Transplant Recipient. Ann Clin Case Rep. 2020; 5: 1848..