AJTMH HINARI
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Am. J. Trop. Med. Hyg., 78(4), 2008, pp. 546-551
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kamgno, J.
Right arrow Articles by Mackenzie, C. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kamgno, J.
Right arrow Articles by Mackenzie, C. D.
Related Collections
Right arrow Loiasis

CASE REPORT


Encephalopathy after Ivermectin Treatment in a Patient Infected with Loa Loa and Plasmodium spp.

Joseph Kamgno, Michel Boussinesq, François Labrousse, Blaise Nkegoum, Björn I. Thylefors, AND Charles D. Mackenzie*
National Onchocerciasis Task Force, Yaounde, Cameroon; Unité de Recherche 24, Institut de Recherche pour le Développement, Paris, France; Service d’Anatomie Pathologique, Hôpital Universitaire Dupuytren, Limoges, France; Centre Hospitalier Universitaire, Yaounde, Cameroon; Mectizan Donation Program, Atlanta, Georgia; Filarial Diseases Unit, Michigan State University, East Lansing, Michigan

 

ABSTRACT

Despite over 350 million people being safely treated with ivermectin, there have been rare cases of death post-treatment; these events are most often associated with high Loa loa microfilaremia. This first autopsy description of an encephalopathy case following the administration of ivermectin involves a 45-year-old male who became comatose 3 days after treatment. He slowly deteriorated over 5 weeks and died at 54 days after the anthelminthic treatment, probably as a result of a secondary skin or pulmonary infection exacerbated by malnutrition. The major pre- and post-autopsy findings included the presence of high loads of Loa loa, positivity for Plasmodium, the presence of a longstanding respiratory condition, and vascular pathology in the brain. The central nervous system lesions have similarities with those described in previously reported cases of Loa loa-associated death following diethylcarbamazine treatment.

Received June 20, 2007. Accepted for publication October 24, 2007.

Acknowledgments: Many of the activities carried out to investigate this case were funded by The Mectizan Donation Program (Atlanta) as part their continuing support of the activities of the Loiasis Program in Cameroon. The Filarial Diseases Unit at Michigan State University is supported by a grant from Glaxo SmithKline. The Histotechnology Laboratory at Michigan State University is thanked for their immunocytochemistry work in this study. The permission given by the patient’s wife and son for the autopsy to be performed is much appreciated. We are also grateful to the Minister of Health, Mr Urbain Olanguena Awono, for his support and interest in the onchocerciasis activities within Cameroon.

* Address correspondence to Charles Mackenzie, Filarial Diseases Unit, Michigan State University, A54 VMC, East Lansing, Michigan 48824. E-mail: mackenz8{at}msu.edu

Authors’ addresses: Joseph Kamgno and Blaise Nkegoum, National Onchoceriasis Task Force, Yaounde, Cameroon, E-mails: jkamgno{at}yahoo.fr and bnkegoum{at}yahoo.fr. Michel Boussinesq, Unite de Researche 24, Institut de Recherche pour le Developpement, Paris, France, E-mail: michel.boussinesq{at}wanadoo.fr. François Labrousse, Service d’Anatomie Pathologique, Hospital Universitaire Dupuytren, Limoges, France, E-mail: labrousse{at}unilim.fr. Björn I. Thylefors, Mectizan Donation Program, Suite 400, 750 Commerce Drive, Decatur, GA 30030, E-mail: bthylefors{at}taskforce.org. Charles Mackenzie, Filarial Diseases Unit, Michigan State University, A54 VMC, East Lansing, MI 48824, Tel: (517) 432-3644, Fax: (517) 353 4364, E-mail: mackenz8{at}msu.edu.




This article has been cited by other articles:


Home page
 Am J Trop Med HygHome page
N. D. Goswami, J. J. Shah, G. R. Corey, and J. E. Stout
Persistent Eosinophilia and Strongyloides Infection in Montagnard Refugees after Presumptive Albendazole Therapy
Am J Trop Med Hyg, August 1, 2009; 81(2): 302 - 304.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the American Society of Tropical Medicine and Hygiene.