AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 79(6), 2008, pp. 853-855
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

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CASE REPORT


Failure of Subcutaneous Ivermectin in Treating Strongyloides Hyperinfection

Victor Leung*, Ghada N. Al-Rawahi, Jennifer Grant, Lawrence Fleckenstein, AND William Bowie
Department of Internal Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, Children’s and Women’s Health Center of British Columbia, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia and Division of Medical Microbiology and Infection Control, Vancouver General Hospital, Vancouver, British Columbia, Canada; Division of Clinical and Administrative Pharmacy, University of Iowa College of Pharmacy, Iowa City, Iowa; Division of Infectious Diseases, University of British Columbia, Vancouver, British Columbia, Canada

 

ABSTRACT

A man with Escherichia coli meningitis and bacteremia, while on dexamethasone, developed Strongyloides hyperinfection syndrome and died despite salvage therapy with subcutaneous ivermectin. We report the first documented total and free levels of subcutaneous ivermectin used for therapy.

Received July 23, 2008. Accepted for publication September 17, 2008.

Acknowledgments: The American Committee on Clinical Tropical Medicine and Travelers’ Health (ACCTMTH) assisted with publication expenses.

* Address correspondence to Victor Leung, 1550 Dr. Penfield, Apt 1406, Montreal, Quebec H3G 1C2. E-mail: victor.leung{at}mail.mcgill.ca

Authors’ addresses: Victor Leung, 1550 Dr. Penfield, Apt 1406, Montreal, Quebec H3G 1C2, Tel: 514-451-8342, Fax: 604-327-2062, Pager: 514-406-3046, E-mail: victor.leung{at}mail.mcgill.ca. Ghada Al-Rawahi, Department of Pathology and Laboratory Medicine, Children’s and Women’s Health Centre of British Columbia, Rm. 2G27, 4500 Oak Street, Vancouver, BC V6H 3N1, Tel: 604-875-2394, Fax: 604-875-3777, E-mail: Ghada.al-rawahi{at}cw.bc.ca. Jennifer Grant, Vancouver General Hospital JPPN, Rm. 1110, 899 W. 12th Avenue, Vancouver, BC V5Z 1M9, Tel: 604-875-4111 ext. 69503, Fax: 604-875-4359, Pager: 604-205-1689, E-mail: jennifer.grant{at}vch.ca. Lawrence Fleckenstein, 115 S. Grand Avenue, College of Pharmacy, University of Iowa, Iowa City, IA 52242, Tel: 319-335-8804, Fax: 319-353-5646, E-mail: l-fleckenstein{at}uiowa.ed. William Bowie, 452D HPE 2733 Heather Street, Vancouver, BC V5Z 3J5, Tel: 604-875-4588, Fax: 604-875-4013, E-mail: bowie{at}interchange.ubc.ca.






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