Thiabendazole Treatment of Severe Strongyloidiasis in a Hemodialyzed Patient

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The progression of asymptomatic or mildly symptomatic Strongyloides stercorals infection to the often fatal hyperinfected state is a well documented complication of immunosuppression (1). Several deaths have been reported in renal transplant recipients given immunosuppressive therapy (2). Although thiabendazole is the preferred treatment for strongyloides, the results of conventional 48-h therapy have been disappointing in the hyperinfected patient. Therefore, therapy for as long as 5 days has been recommended (3). Because thiabendazole is rapidly metabolized to 5-hydroxy-metabolites, which are eliminated predominantly by the kidney, the dosage may need to be modified with longer therapy in patients with renal failure. We

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