{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:32:42Z","timestamp":1790271162617,"version":"4.1.0"},"reference-count":48,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,10,5]]},"abstract":"<jats:p><jats:italic>Strongyloides stercoralis<\/jats:italic> is well known to cause hyperinfection syndrome during the period of immunosuppression; but dissemination, worsening hyperinfection, and development of multiorgan dysfunction syndrome after initiation of ivermectin has not been reported in the past. Herein, we describe the case of a 62-year-old man with chronic strongyloidiasis and human T-cell lymphotropic virus-1 coinfection, who developed significant clinical worsening after 24\u201348 hours of initiation of treatment with ivermectin (200 \u03bcg\/kg daily). Oral albendazole (600 mg every 12 hours) was added to the regimen due to clinical deterioration. Notably, after a protracted clinical course with multiple complications, which included respiratory failure from gram-negative pneumonia and pulmonary alveolar hemorrhage, <jats:italic>Klebsiella<\/jats:italic> meningitis, <jats:italic>Clostridium difficile<\/jats:italic> colitis, and herpes labialis, the patient eventually recovered. Health-care providers should be aware that during the early days of antihelminthic treatment initiation, significant dissemination of <jats:italic>S. stercoralis<\/jats:italic> and worsening of the clinical scenario can occur.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0259","type":"journal-article","created":{"date-parts":[[2016,8,16]],"date-time":"2016-08-16T00:43:10Z","timestamp":1471308190000},"page":"864-867","source":"Crossref","is-referenced-by-count":12,"title":["Multiorgan Dysfunction Syndrome from Strongyloides stercoralis Hyperinfection in a Patient with Human T-Cell Lymphotropic Virus-1 Coinfection After Initiation of Ivermectin Treatment"],"prefix":"10.4269","volume":"95","author":[{"given":"Tatvam T.","family":"Choksi","sequence":"first","affiliation":[{"name":"1Department of Internal Medicine, Mercy Philadelphia Hospital, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gul","family":"Madison","sequence":"additional","affiliation":[{"name":"2Department of Infectious Diseases, Mercy Philadelphia Hospital, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tawseef","family":"Dar","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine, Mercy Philadelphia Hospital, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Asif","sequence":"additional","affiliation":[{"name":"3Department of Surgery, Mercy Philadelphia Hospital, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Fleming","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine, Mercy Philadelphia Hospital, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon","family":"Clarke","sequence":"additional","affiliation":[{"name":"3Department of Surgery, Mercy Philadelphia Hospital, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mervyn","family":"Danilewitz","sequence":"additional","affiliation":[{"name":"4Department of Gastroenterology, Mercy Philadelphia Hospital, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randa","family":"Hennawy","sequence":"additional","affiliation":[{"name":"5Department of Pathology, Mercy Philadelphia Hospital, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Clin Microbiol Rev","first-page":"208","article-title":"Strongyloides stercoralis in the immunocompromised population","volume":"17","author":"Keiser","year":"2004"},{"key":"ref2","series-title":"Am 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