Strongyloides – pre-immunosuppression — RACP Paediatrics MCQ

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HardIDStrongyloides – pre-immunosuppressionRACP Paediatrics

A 4-year-old from a remote Aboriginal community has chronic Strongyloides stercoralis infection. She is about to commence immunosuppressive therapy for nephrotic syndrome. What must be done before immunosuppression?

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Correct answer: C — Ivermectin

Strongyloides must be treated before immunosuppression to prevent potentially fatal hyperinfection syndrome (disseminated strongyloidiasis). Ivermectin (200 mcg/kg daily for 2 days) is the treatment of choice. Screening for Strongyloides (serology or stool) before immunosuppression is essential in at-risk populations, including Aboriginal Australians.

Reference: Australian Therapeutic Guidelines – 2024 – Antibiotic; RACP Paediatric Curriculum – ID