Severe Strongyloidiasis in Solid Organ Transplant Recipients: Should We Preventively Treat the Recipient, the Donor, or Both?

Strongyloidiasis is caused by a soil-transmitted helminth that is endemic in tropical and subtropical countries. The parasite can complete its life cycle without leaving the host, allowing autoinfection and persistence. The risk of infection in travelers is low, but the disease may become lethal fol...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2018-01, Vol.98 (4), p.941-944
Main Authors: Eperon, Gilles, Tourret, Jerome, Ailioaie, Oana, Paris, Luc, Mercadal, Lucile, Mayaux, Julien, Caumes, Eric, Barrou, Benoit
Format: Article
Language:English
Subjects:
Aged
Animals
Female
Human health and pathology
Humans
Immunosuppression
Infections
Kidney Transplantation - adverse effects
Life Sciences
Male
Middle Aged
Piece
Practice Guidelines as Topic
Strongyloides stercoralis - immunology
Strongyloidiasis - diagnosis
Strongyloidiasis - parasitology
Strongyloidiasis - prevention & control
Strongyloidiasis - transmission
Tissue Donors
Transplant Recipients
Transplants & implants
Travel
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Summary:Strongyloidiasis is caused by a soil-transmitted helminth that is endemic in tropical and subtropical countries. The parasite can complete its life cycle without leaving the host, allowing autoinfection and persistence. The risk of infection in travelers is low, but the disease may become lethal following immunosuppression. In case of solid organ transplantation, the risk of donor transmission has been suspected for several years. However, the management of live donors in this context has only recently been considered, and no guidelines exist for the management of deceased donors. To highlight the complexity of diagnosing, treating, and preventing strongyloidiasis donor transmission, we describe a case of possible transmission of severe strongyloidiasis to a kidney transplant recipient with limited travel history. Taking into account the difficulty of diagnosing chronic strongyloidiasis infection and the increase in travel and immunosuppressive treatments, we recommend pragmatic management guidelines to limit the risks of infection.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.17-0234