A 55-year-old male, undergoing chronic CAPD due to renal failure secondary to chronic glomerulonephritis.
She received a renal transplant from a cadaver donor in July 2005 and immunosuppression with tacrolimus, mycophenolate mofetil and prednisone. She had stable renal function with creatinine around 2.5 mg/dl. At two years of transplantation she had persistent diarrhea.
Microbiological study of feces detected abundant larvae of S. stercoralis.
Eosinophil counts in blood were normal (0.3 x 103/μl).
The patient was bedridden in a Valencian locality considered an endemic area of S. stercoralis.
Previous history of urticaria and mild asthma that the patient had sporadically treated with bronchodilators were reviewed.
In the pretransplant analytical presented mild intermittent form (1.0 x 103/μl).
Treatment with thiabendazole was initiated at a dose of 1.5 g/12 hours (25 mg/kg/day) orally for five days, repeating the cycle at seven days due to persistence of the clinic.
Diarrhoea persisted 14 days after the start of treatment, with weight loss of 4 kg and deterioration of renal function, so she was admitted for intravenous hydration.
The stool sample obtained during admission, as well as that obtained after the second treatment with thiabendazole, were negative for parasites.
Diarrhea improved, with progressive recovery of renal function to normal creatinine levels.
A new stool sample was negative one month later.
Currently, the patient remains asymptomatic, with improvement of urticarriform symptoms and asthma, with stable renal function.
The relatives living together were studied, detecting in the son of the patient the presence of S. stercoralis that was treated as outpatient with thiabendazole.
