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Open Access Highly Accessed Case report

An unusual cause of alveolar hemorrhage post hematopoietic stem cell transplantation: A case report

Sachin Gupta1, Amit Jain1, Tina V Fanning2, Daniel R Couriel3, Carlos A Jimenez1 and Georgie A Eapen1*

Author Affiliations

1 Department of Pulmonary Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA

2 Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA

3 Department of Blood and Marrow Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA

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BMC Cancer 2006, 6:87  doi:10.1186/1471-2407-6-87

Published: 7 April 2006

Abstract

Background

Hematopoietic stem cell transplantation is being increasingly used in cancer therapy. Diffuse alveolar hemorrhage, an early complication of stem cell transplant, results from bacterial, viral and fungal infections, coagulopathy, and engraftment syndrome, or can be idiopathic. Diffuse alveolar hemorrhage associated with Strongyloides stercoralis hyperinfection in stem cell transplant patients has been rarely reported.

Case presentation

We describe an unusual cause of alveolar hemorrhage post hematopoietic stem cell transplant due to Strongyloides hyperinfection. Therapy with parenteral ivermectin and thiabendazole was initiated but the patient deteriorated and died of respiratory failure and septic shock.

Conclusion

Strongyloides stercoralis hyperinfection is an unusual cause of alveolar hemorrhage early after hematopoietic stem cell transplant with very high mortality.