Strongyloides infection manifested during immunosuppressive therapy for SARS-CoV-2 pneumonia

BACKGROUND: SARS-CoV-2 pandemic has posed formidable public health and clinical challenges. The use of immunosuppressive agents, such as high dose corticosteroids and cytokine inhibitors (e.g., Tocilizumab) has been suggested to contrast the hyperinflammatory process involved in the pathogenesis of the severe disease, with conflicting evidence. Among the drawbacks of immunosuppressive therapy, the risk of reactivation of latent infections, including parasitic infestations, is to be considered.

CASE PRESENTATION: We report a case of a 59-year-old Italian patient treated with high dose intravenous dexamethasone and two intravenous doses of Tocilizumab for interstitial bilateral pneumonia associated with SARS-CoV-2 infection who developed itching, abdominal pain, and an increased eosinophil count. Stool examination confirmed the presence of S. stercoralis larvae. The patient was treated with a 4-day course of Ivermectin with full recovery.

DISCUSSION: We report the first case of S. stercoralis infection following an 11-day treatment with high-dose steroids and Tocilizumab for severe COVID-19. Clinicians should be aware of the risk of strongyloidiasis as a complication of the treatment for severe COVID-19.

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

Infection - Vol. 49, No. 3 (2021), p. 539-542

Language:

English

Contributors:

Marchese, Valentina
Crosato, Verena
Gulletta, Maurizio
Castelnuovo, Filippo
Cristini, Graziella
Matteelli, Alberto
Castelli, Francesco

Links:

Volltext

Keywords:

70288-86-7
7S5I7G3JQL
Animals
Antibodies, Monoclonal, Humanized
Antiparasitic Agents
COVID-19
Case Reports
Dexamethasone
Feces
Female
Humans
I031V2H011
Immunosuppression
Immunosuppressive Agents
Ivermectin
Journal Article
Latent Infection
Middle Aged
SARS-CoV-2
Strongyloides stercoralis
Strongyloidiasis
Tocilizumab
Treatment Outcome

Notes:

Date Completed 07.06.2021

Date Revised 07.06.2021

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1007/s15010-020-01522-4

PMID:

32910321

PPN (Catalogue-ID):

NLM315778075