{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T14:34:25Z","timestamp":1762353265508,"version":"build-2065373602"},"reference-count":12,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Strongyloides<\/jats:italic>\n                    hyperinfection can be challenging to diagnose and treat. Although it is typically described in cases of secondary immunodeficiency, it has not previously been reported in a case of inborn error of immunity. Diagnosis via microscopy can be time-consuming and challenging, and serology results may be negative in the setting of hypogammaglobulinemia. Oral ivermectin is an effective treatment for strongyloidiasis and is commonly used in low-endemicity countries. However, its efficacy is limited in cases of malabsorption. Subcutaneous administration of ivermectin is widespread in veterinary medicine, but it is not licensed for use in humans. The use of subcutaneous ivermectin in the treatment of\n                    <jats:italic>Strongyloides<\/jats:italic>\n                    hyperinfection is described in a man with hypogammaglobulinemia secondary to common variable immune deficiency and associated severe malnutrition in the context of chronic\n                    <jats:italic>Strongyloides<\/jats:italic>\n                    -related malabsorption. The diagnostic challenges in low-endemicity settings and therapeutic considerations when oral therapy is unsuccessful are also discussed.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0146","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T14:29:38Z","timestamp":1755786578000},"page":"1031-1034","source":"Crossref","is-referenced-by-count":0,"title":["Strongyloides Hyperinfection Treated with Subcutaneous Ivermectin in a Patient with an Inborn Error of Immunity"],"prefix":"10.4269","volume":"113","author":[{"given":"Peter","family":"Conlon","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Beaumont Hospital, Dublin, Ireland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fergal","family":"Howley","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Beaumont Hospital, Dublin, Ireland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Al Sharqi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Beaumont Hospital, Dublin, Ireland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Beverland","sequence":"additional","affiliation":[{"name":"Department of Immunology, Beaumont Hospital, Dublin, Ireland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fionnuala","family":"Cox","sequence":"additional","affiliation":[{"name":"Department of Immunology, Beaumont Hospital, Dublin, Ireland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aisling","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Guys and St Thomas\u2019 NHS Foundation Trust, London, United Kingdom;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eoghan","family":"de Barra","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Beaumont Hospital, Dublin, Ireland;"},{"name":"Department of International Health and Tropical Medicine, Royal College of Surgeons, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"PLoS Negl Trop Dis","first-page":"e0007609","article-title":"A global genotyping survey of Strongyloides stercoralis and Strongyloides fuelleborni using deep amplicon sequencing","volume":"13","author":"Barratt","year":"2019"},{"key":"b2","series-title":"J Antibiot (Tokyo)","first-page":"495","article-title":"Ivermectin: Enigmatic multifaceted \u2018wonder\u2019 drug continues to surprise and exceed expectations","volume":"70","author":"Crump","year":"2017"},{"key":"b3","series-title":"Gastroenterol Hepatol (NY)","first-page":"766","article-title":"Strongyloides stercoralis hyperinfection syndrome and disseminated disease","volume":"7","author":"Kassalik","year":"2011"},{"key":"b4","series-title":"Trans R Soc Trop Med Hyg","first-page":"314","article-title":"Strongyloides hyperinfection syndrome: An emerging global infectious disease","volume":"102","author":"Marcos","year":"2008"},{"key":"b5","series-title":"BMC Infect Dis","first-page":"78","article-title":"Severe strongyloidiasis: A systematic review of case reports","volume":"13","author":"Buonfrate","year":"2013"},{"key":"b6","series-title":"J Antimicrob Chemother","first-page":"220","article-title":"Subcutaneous ivermectin use in the treatment of severe Strongyloides stercoralis infection: Two case reports and a discussion of the literature","volume":"71","author":"Barrett","year":"2016"},{"key":"b7","series-title":"BMJ Case Rep","first-page":"bcr2017223138","article-title":"Successful use of subcutaneous ivermectin for the treatment of Strongyloides stercoralis hyperinfection in the setting of small bowel obstruction and paralytic ileus in the immunocompromised population","volume":"2018","author":"Zeitler","year":"2018"},{"key":"b8","series-title":"Int J Antimicrob Agents","first-page":"580","article-title":"Strongyloides disseminated infection successfully treated with parenteral ivermectin: Case report with drug concentration measurements and review of the literature","volume":"42","author":"Donadello","year":"2013"},{"key":"b9","series-title":"Transpl Infect Dis","first-page":"137","article-title":"Hyperinfection strongyloidiasis in a liver transplant recipient treated with parenteral ivermectin","volume":"11","author":"Lichtenberger","year":"2009"},{"key":"b10","series-title":"Am J Trop Med Hyg","first-page":"911","article-title":"Parenteral administration of ivermectin in a patient with disseminated strongyloidiasis","volume":"73","author":"Turner","year":"2005"},{"key":"b11","series-title":"Am J Rhinol Allergy","first-page":"260","article-title":"Common variable immunodeficiency","volume":"27","author":"Tam","year":"2013"},{"year":"2016","series-title":"Core Concepts in Clinical Infectious Diseases","author":"Franco-Parades","key":"b12"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/5\/article-p1031.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/5\/article-p1031.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/5\/article-p1031.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T14:23:26Z","timestamp":1762352606000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/5\/article-p1031.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":12,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.25-0146","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"type":"print","value":"0002-9637"},{"type":"electronic","value":"1476-1645"}],"subject":[],"published":{"date-parts":[[2025,11,5]]}}}