Case Report: Ivermectin and Albendazole Plasma Concentrations in a Patient with Disseminated Strongyloidiasis on Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy

Carl Boodman Department of Medicine, University of British Columbia, Vancouver, Canada;

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Yashpal S. Chhonker University of Nebraska Medical Centre, Omaha, Nebraska;

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Daryl J. Murry University of Nebraska Medical Centre, Omaha, Nebraska;

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Allison Mah Department of Medicine, University of British Columbia, Vancouver, Canada;

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Jennifer Grant Department of Medicine, University of British Columbia, Vancouver, Canada;
Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada;

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Theodore Steiner Department of Medicine, University of British Columbia, Vancouver, Canada;

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Michael Libman J. D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Canada;

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Cesilia Nishi Department of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada

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Marthe Charles Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada;

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Disseminated strongyloidiasis is often fatal, despite treatment with oral albendazole and parenteral ivermectin (IVM). Here, we report elevated plasma IVM and albendazole sulfoxide concentrations in the context of extracorporeal membrane oxygenation and continuous renal replacement therapy in a patient with disseminated strongyloidiasis treated with subcutaneous IVM and nasogastric albenzadole. Despite elevated drug plasma concentrations, live filariform larvae were detected in endotracheal aspirates after 2 weeks of treatment.

Author Notes

Address correspondence to Carl Boodman, Department of Medicine, University of British Columbia, Laurel Street, 10th Floor, Vancouver, BC Canada V5Z 1M9. E-mail: carl.boodman@alumni.ubc.ca

Authors’ addresses: Carl Boodman, Department of Medicine, University of British Columbia, Vancouver, Canada, E-mails: carl.boodman@alumni.ubc.ca or carl.boodman@mail.mcgill.ca. Yashpal S. Chhonker and Daryl J. Murry, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, E-mails: y.chhonker@unmc.edu and dj.murry@unmc.edu. Allison Mah, Jennifer Grant, and Theodore Steiner, Division of Infectious Diseases, University of British Columbia, Vancouver, Canada, E-mails: allimah@mail.ubc.ca, Jennifer.Grant@vch.ca, and tsteiner@mail.ubc.ca. Michael Libman, J. D. MacLean Centre for Tropical Medicine, McGill University, Montreal, Canada, E-mail: michael.libman@mcgill.ca. Cesilia Nishi, Department of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada, E-mail: cesilia.nishi@vch.ca. Marthe Charles, Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada, E-mail: marthe.charles@vch.ca.

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