Strongyloides stercoralis Hyperinfection in an HIV-Infected Patient Successfully Treated with Subcutaneous Ivermectin

• Main Authors: Paolo Antonio Grossi, Domenico Lombardi, Alessia Petrolo, Cristina Rovelli, Zaira Di Rosa, Giorgio Perriccioli, Agostino Rossi, Giulio Minoja, Francesco Scaglione, Daniela Dalla Gasperina
• Format: Article
• Language: English
• Published: MDPI AG 2018-04-01
• Series: Tropical Medicine and Infectious Disease
• Subjects: Strongyloides stercoralis; hyperinfection; HIV; parenteral ivermectin
• Online Access: http://www.mdpi.com/2414-6366/3/2/46

A 39-year-old Ethiopian HIV-positive man with peripheral T-cell lymphoma developed Strongyloides stercoralis hyperinfection. The patient was initially treated with oral ivermectin for three weeks without response, most likely due to malabsorption because of concomitant paralytic ileus. Given the persistence of larvae in the body fluids, the worsening respiratory status and clinical malabsorption, veterinary parenteral formulation of ivermectin was administered. The very high plasma concentration of ivermectin achieved in the patient after parenteral administration led to a rapid improvement in his clinical condition and rapid disappearance of the parasite from biological samples, without any adverse reaction.