Case Report: A Case of Recurrent Strongyloides stercoralis Colitis in a Patient with Multiple Myeloma

Keith Glenn Wright-Patterson Medical Center, Wright-Patterson Air Force Base, Ohio

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David A. Lindholm Wright-Patterson Medical Center, Wright-Patterson Air Force Base, Ohio

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Gregory Meis Wright-Patterson Medical Center, Wright-Patterson Air Force Base, Ohio

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Luisa Watts Wright-Patterson Medical Center, Wright-Patterson Air Force Base, Ohio

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Nicholas Conger Wright-Patterson Medical Center, Wright-Patterson Air Force Base, Ohio

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Strongyloides stercoralis chronic infection is frequently subclinical and thus under-recognized, although its increasing prevalence in nonendemic regions has implications for immunocompromised hosts. We present a 75-year-old male with stage II multiple myeloma who presented with relapse of Strongyloides infection after initial treatment, negative surveillance testing, and subsequent resumption of chemotherapy for his multiple myeloma. The optimal regimen for secondary prophylaxis against recurrent infections is unknown. Secondary prophylaxis should be considered for patients who recur and/or remain at high risk of recurrence because of ongoing immunosuppression. We implemented a prophylactic regimen of ivermectin 200 mcg/kg once monthly. In addition, improved laboratory assays for strongyloidiasis are needed to aid with diagnosis, monitoring of treatment response, and early detection of relapse.

Author Notes

Address correspondence to Keith Glenn, Wright-Patterson Medical Center, 4881 Sugar Maple Drive, Wright-Patterson Air Force Base, OH 45433. E-mail: Keith.r.glenn@gmail.com

Authors’ addresses: Keith Glenn, David A. Lindholm, Gregory Meis, Luisa Watts, and Nicholas Conger, Wright-Patterson Medical Center, Wright-Patterson Air Force Base, OH, E-mails: keith.r.glenn@gmail.com, david.lindholm@us.af.mil, gregory.meis@us.af.mil, luisa.watts.3@us.af.mil, and nicholas.conger@us.af.mil.

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