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Journal of Medical Case Reports

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Open Access 01-12-2023 | River Blindness | Case report

Successful management of poisoning with ivermectin (Mectizan) in the Obala health district (Centre Region, Cameroon): a case report

Authors: Cyrille Donfo-Azafack, Hugues C. Nana-Djeunga, Guy Wafeu-Sadeu, Raïssa Dongmo-Yemele, Joseph Kamgno

Published in: Journal of Medical Case Reports | Issue 1/2023

Abstract

Background

Ivermectin (Mectizan) is an anthelmintic drug that plays a major role in the fight against two major filarial diseases, onchocerciasis and lymphatic filariasis. Unlike previous drugs that had serious and sometimes fatal side effects, ivermectin has been considered to be safe and, therefore, is widely used. Data reporting the clinical presentation of poisoning with ivermectin are very scanty, even in experimental studies.

Case presentation

In this paper, we report the case of a 19-year-old Black African female student residing in Obala (Centre Region, Cameroon) who was admitted to a health facility in Central Cameroon for a neurological disorder after intoxication with about 400 tablets of ivermectin 3 mg (~100 times the standard doses). This neurological disorder was characterized by somnolence, kinetic ataxia, increase of tendon reflex, and central visual disturbance. Management of this intoxication consisted of symptomatic treatment and monitoring of hemodynamic parameters for 5 days, with a favorable course.

Conclusions

This is the first report of a poisoning with ivermectin at ~100 times the recommended dose. This case report confirms the safety and tolerability of ivermectin, even at exceptionally high dose.

Campbell WC, Fisher MH, Stapley EO, Albers-Schonberg G, Jacob TA. Ivermectin: a potent new antiparasitic agent. Science. 1983;221:823–8.CrossRefPubMed

Develoux M. Ivermectine. Ann Dermatol Venereol. 2004;131:561–70.CrossRefPubMed

Geary TG. Ivermectin 20 years on: maturation of a wonder drug. Trends Parasitol. 2005;21(11):530–2.CrossRefPubMed

Boatin BA, Hougard JM, Alley ES, Akpoboua LK, Yameogo L, Dembele N, Seketeli A, Dadzie KY. The impact of Mectizan on the transmission of onchocerciasis. Ann Trop Med Parasitol. 1998;92(Suppl 1):S46-60.PubMed

Aziz MA, Diallo S, Lariviere M, Diop IM, Porta IM, Gaxotte P. Ivermectin in onchocerciasis. Lancet. 1982;2(8313):1456–7.CrossRefPubMed

Twum-Danso NA. Loa loa encephalopathy temporally related to ivermectin administration reported from onchocerciasis mass treatment programs from 1989 to 2001: implications for the future. Filaria J. 2003;2(Suppl 1):S7.CrossRefPubMedPubMedCentral

Gardon J, Gardon-Wendel N, Demanga N, Kamgno J, Chippaux JP, Boussinesq M. Serious reactions after mass treatment of onchocerciasis with ivermectin in an area endemic for Loa loa infection. Lancet. 1997;350:18–22.CrossRefPubMed

Navarro M, Camprubí D, Requena-Méndez A, Buonfrate D, Giorli G, Kamgno J, Gardon J, Boussinesq M, Muñoz J, Krolewiecki A. Safety of high-dose ivermectin: a systematic review and meta-analysis. J Antimicrob Chemother. 2020;75(4):827–34.CrossRefPubMed

Guzzo CA, Furtek CI, Porras AG, Chen C, Tipping R, Clineschmidt CM, Sciberras DG, Hsieh JYK, Lasseter KC. Safety, tolerability, and pharmacokinetics of escalating high doses of ivermectin in healthy adult subjects. J Clin Pharmacol. 2002;42:1122–33.CrossRefPubMed

10.

Duthaler U, Suenderhauf C, Karlsson MO, Hussner J, Schwabedissen HM, Krähenbühl S, Hammann F. Population pharmacokinetics of oral ivermectin in venous plasma and dried blood spots in healthy volunteers. Br J Clin Pharmacol. 2019;85:626–33.CrossRefPubMedPubMedCentral

11.

Trailovic SM, Nedeljkovic JT. Central and peripheral neurotoxic effects of ivermectin in rats. J Vet Med Sci. 2011;73:591–9.CrossRefPubMed

12.

Pulliam JD, Seward SR, Henry RT, Steinberg SA. Investigating ivermectin toxicity in collies. Vet Med. 1985;80:33–40.

13.

Fobi G, Gardon J, Kamgno J, Aimard-Favennec L, Lafleur C, Gardon-Wendel N, Duke BOL, Boussinesq M. A randomized, double-blind, controlled trial of the effects of ivermectin at normal and high doses, given annually or three-monthly, against Onchocerca volvulus: ophthalmological results. Trans R Soc Trop Med Hyg. 2005;99:279–89.CrossRefPubMed

14.

Patte M, Sillaire I, Pauchard E, Coulangeon LM, Kantelip B, Bacin F. Barrières hémato-oculaires. Physiologie. 2006;3:1–12.

Title: Successful management of poisoning with ivermectin (Mectizan) in the Obala health district (Centre Region, Cameroon): a case report
Authors: Cyrille Donfo-Azafack
Hugues C. Nana-Djeunga
Guy Wafeu-Sadeu
Raïssa Dongmo-Yemele
Joseph Kamgno
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: River Blindness
Intoxication
Ivermectin
Published in: Journal of Medical Case Reports / Issue 1/2023
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-023-03891-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Successful management of poisoning with ivermectin (Mectizan) in the Obala health district (Centre Region, Cameroon): a case report

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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