Hyperinfection by Strongyloides stercoralis probably associated with Rituximab in a patient with mantle cell lymphoma and hyper eosinophilia

Rev Inst Med Trop Sao Paulo. 2010 Jul-Aug;52(4):221-4. doi: 10.1590/s0036-46652010000400011.

Abstract

The first report to our knowledge, of hyperinfection by Strongyloides stercoralis (HS) and hypereosinophilia, associated to immune suppression by Rituximab (the only drug received for the last one year and 10 months), in a patient with mantle-cell lymphoma (MCL), is presented. The patient has a 3-year history of MCL, and developed two accesses of HS during 2008, including meningitis, pneumonia and presence of larvae of S. stercoralis in the lungs. We had a unique chance to look at cytotoxicity of filariform larvae in the expectoration after Ivermectin treatment, showing immobilization and death of larvae, associated with eosinophils attached to the cuticle of the parasite.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Antibodies, Monoclonal, Murine-Derived / adverse effects*
  • Antineoplastic Agents / adverse effects*
  • Antiparasitic Agents / therapeutic use
  • Female
  • Humans
  • Hypereosinophilic Syndrome / immunology
  • Immunocompromised Host*
  • Ivermectin / therapeutic use
  • Lymphoma, Mantle-Cell / drug therapy
  • Lymphoma, Mantle-Cell / immunology
  • Middle Aged
  • Rituximab
  • Strongyloidiasis / drug therapy
  • Strongyloidiasis / immunology*
  • Superinfection / immunology*
  • Superinfection / parasitology

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents
  • Antiparasitic Agents
  • Rituximab
  • Ivermectin