There was an extensive discussion at case-rounds yesterday afternoon about prophylaxis for strongyloidiasis in patients at risk who will be immunosuppressed.
Here is a review of strongyloidiasis in the immunocomprimised patient.
This article discusses prevention in patients with connective tissue diseases.
In patients with bone marrow transplantation or solid organ transplantation recent guidelines suggest that patients with unexplained eosinophilia or who have lived/travelled in areas endemic for strongyloidiasis, even if remotely, should be screened prior to transplant with stool O&P time three and serology. Positive screening or eosinophilia should prompt pre-emptive treatment prior to transplant with ivermectin. Mind you, some experts would suggest, given the few side effects, that people who have lived in endemic areas should just be treated...
Recent case report of death due to strongyloides in patient with HSCT...
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