Fatal Multiorgan Failure Syndrome in a -HTLV-1 Coinfected Patient, after Treatment with Ivermectin.

Because of its characteristic features of autoinfection, the parasitic nematode can infect patients for years. An acceleration of its autoinfective cycle can be triggered by human T-lymphotropic virus-1 (HTLV-1) infection, mainly by the deviation of the protective Th2- to Th1-type immune response and can lead to severe disease by dissemination of larvae carrying intestinal bacteria to multiple organs. Meningitis caused by enteric Gram-negative bacteria is a potentially fatal complication of disseminated strongyloidiasis. Herein, we present the case of a -HTLV-1 coinfected patient, admitted for meningitis. One day after initiation of ivermectin, the patient developed significant dissemination, complicated by multiorgan failure syndrome, and died from neurological failure. While the initial clinical scenario of our case has already been well described in the literature, its course after antihelminthic treatment initiation remains unclear and needs to be discussed.