We report the case of a 44-year-old female with systemic lupus erythematodes who presented with a severe case of strongyloides infection after immune- suppressant therapy with high dose steroids and rituximab. Due to the endemic nature of this helminthic disease we suspect an asymptomatic infection at least a year prior during visits to the patient's home country Brazil. As a result from the intensified immunosuppressant therapy, a manifest disseminated infection via accelerated auto-infection developed which caused the clinical symptoms. The infection was successfully treated with the antimycotic drugs ivermectine and albendazole. A follow-up of more than two years later showed signs of ongoing, though clinical asymptomatic infection. This was treated again successfully with ivermectine. Because of the patient's underlying autoimmune disease and listing for kidney transplantation due to end stage renal disease, regular follow-ups will be continued for early detection of signs of (auto) infection.
Published Date: 2019-03-22; Received Date: 2018-11-19