Cure by ivermectin of a chronic, persistent, intestinal strongyloidosis

A report is given of a cure by ivermectin of a 19-year-old patient with chronic, persistent, 3-year-old intestinal strongyloidosis resistant to several dosage regimens of conventional anthelminthics, including the current drug of choice for strongyloidosis thiabendazole and its therapeutic alternative, albendazole. Ivermectin was administered, first as a single, oral dose of 200 mu g/kg with consequent reduction in larval output, but no complete parasitological cure. A second course of ivermectin, 200 mu g/kg administered for two consecutive days, resulted in complete parasitological cure, as evidenced by the absence of Strongyloides stercoralis larvae in stool samples examined through the kato thick smears, Baermanns concentrations as well as in the 'enterotest' performed on jejunal fluid. The patient has remained parasitologically cured, after 7-months follow-up. Ivermectin was well tolerated with mild clinical and biochemical reactions which did not last for long. (C) 1997 Elsevier Science B.V.