Fatal pancytopenia due to albendazole treatment for strongyloidiasis
Fanfan Xing,
Haiyan Ye,
Jin Yang,
Jasper Fuk-Woo Chan,
Wai-Kay Seto,
Pearl Ming-Chu Pai,
Kwok-Yung Yuen,
Derek Ling-Lung Hung
Affiliations
Fanfan Xing
Department of Clinical Microbiology and Infection Control, The University of Hong Kong – Shenzhen Hospital, Shenzhen, China
Haiyan Ye
Department of Clinical Microbiology and Infection Control, The University of Hong Kong – Shenzhen Hospital, Shenzhen, China
Jin Yang
Department of Clinical Microbiology and Infection Control, The University of Hong Kong – Shenzhen Hospital, Shenzhen, China
Jasper Fuk-Woo Chan
Department of Clinical Microbiology and Infection Control, The University of Hong Kong – Shenzhen Hospital, Shenzhen, China; State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong Special Administrative Region, China; Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China; Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Wai-Kay Seto
Department of Clinical Microbiology and Infection Control, The University of Hong Kong – Shenzhen Hospital, Shenzhen, China; Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
Pearl Ming-Chu Pai
Department of Clinical Microbiology and Infection Control, The University of Hong Kong – Shenzhen Hospital, Shenzhen, China; Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
Kwok-Yung Yuen
Department of Clinical Microbiology and Infection Control, The University of Hong Kong – Shenzhen Hospital, Shenzhen, China; State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong Special Administrative Region, China; Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China; Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China; The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The University of Hong Kong, Hong Kong Special Administrative Region, China
Derek Ling-Lung Hung
Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China; Corresponding author.
We report 7 cases of strongyloidiasis that had occurred from 2016 through 2017 in a tertiary hospital of southern China. Three of the 7 patients (age 66–77) with farming exposure many years ago developed symptomatic infection while receiving immunosuppressant for underlying medical conditions. The majority of them were treated with albendazole due to unavailability of ivermectin in mainland China. One of the 7 patients, with underlying IgG4 sclerosing cholangitis and secondary biliary cirrhosis was on immunosuppressives and developed severe pancytopenia 15 days after albendazole treatment. He ultimately died of polymicrobial sepsis. This was the second fatal case being reported in the literature as a consequence of albendazole-induced myelosuppression. We have undertaken a review of the literature regarding the use of albendazole for strongyloidiasis and its adverse effect with a focus on myelosuppression as a rare but potentially serious event. Keywords: Strongyloidiasis, Immunocompromised, Albendazole, Adverse effect, Pancytopenia
