Two New England men have been left riddled with parasitic worms after receiving a common organ transplant.
The patients, 61 and 66, had each received one kidney each from the same donor, who was from the Caribbean.
The first patient, who was not named, received the transplant from Massachusetts General Hospital in Boston and initially improved.
But 10 weeks later, the man was re-admitted due to suffering from severe thirst and abdominal discomfort. A large purple rash, like a constellation of bruises, had also erupted across the skin of his stomach.
The second patient, who was also unnamed, received their transplant at Albany Medical Center in New York and also improved at first.
Eleven weeks later, however, he was also re-admitted with fatigue, worsening kidney function and a plummeting white blood cell count.
Doctors were initially stumped as to what could be behind the complications, having ruled out Covid, the flu and bacterial infections — after a course of antibiotics did not improve their symptoms.
However, samples from the first patient’s abdomen, lungs and skin revealed a small ringworm called Strongyloides stercoralis. The second patient, meanwhile, was also found to have larvae from Strongyloides stercoralis in his stool.
Two men in Massachusetts and New York were infected with parasites after receiving kidneys from the same deceased donor (stock image)
The above image shows larval worms in one of the patients
The bizarre cases were revealed in The New England Journal of Medicine last month, with doctors treating them as a cautionary tale for better regulation surrounding organ donation.
Transplant organs, donors and recipients normally go through a battery of tests to minimize the risk of the organs being rejected by the body. Blood is tested for antibodies that might attack other tissues, while donors and recipients are both evaluated for infectious diseases like HIV and hepatitis.
They are also usually tested for parasitic infections, but it’s possible the donor was not evaluated for these.
About 48,000 organ transplants take place in the US every year, of which kidney transplants are the most common — making up two-thirds of these procedures.
The most common complication of the procedure is infection, which is common since recipients have to take medications that suppress their immune system.
The above image shows the constellation-like rash the first patient developed after his transplant
Doctors treating one of the man called the New England Donor Services and found the kidney donor had antibodies for Strongyloides, meaning the donor had encountered the parasite at some point.
The recipients only had Strongyloides antibodies after their procedures and not before, meaning they likely got it from their organ donor.
Strongyloides is a roundworm parasite that spreads by directly penetrating human skin that gets into contact with soil. Infections lead to stomach aches, diarrhea and rashes, but most patients don’t know they’re infected.
The CDC doesn’t consistently track US cases, though it’s estimated Strongyloides hospitalizes thousands each year.
The first patient was treated with ivermectin, a deworming drug touted for but largely unproven to treat conditions like Covid and cancer. The second patient received ivermectin and the similar drug albendazole.
Both men have fully recovered.
