A 51-year-old male with renal failure secondary to Alport syndrome on hemodialysis since 2003.
He received a renal graft from a cadaver donor in August 2006, immunosuppression with tacrolimus, mycophenolate mofetil and prednisone.
The patient remained with stable renal function with creatinine levels around 2 mg/dl. The patient presented from the immediate post-transplantation a mild diarrhea picture of 4-5 soft stools a day, which was attributed mycophenolate mofetil.
He also had normocytic normochromic anemia disproportionate to the degree of renal failure, which did not respond to treatment with erythropoietic agents.
Seven months after the transplant, the patient was observed to have post-transplant absolute check-ups x 103/μ. The patient continued to present the same clinical signs and symptoms of soft tissue infections.
She had neither urticaria nor asthma.
Stool examination showed abundant larvae of S. stercoralis.
Treatment was initiated with albendazole at doses of 400 mg every 12 hours orally for three weeks.
After the end of the first cycle of treatment, the patient presented normalization of the number of stools per day, with an improvement in creatinine clearance 0.8 x 103/μl and normalization of hemoglobin levels.
After this first cycle of albendazole, the stool sample was negative for S. stercoralis.
Subsequently, two new cycles of one week of treatment were performed one month and two months after diagnosis, with total normalization of eosinophils in peripheral blood.
Pathways compatible with Blastocystis hominis and with Endolimax nana in the patient's wife, which was treated with oral metronidazole, were detected in relatives living together.
Both are located in an endemic area for S. stercoralis.
