• Joseph Kamgno, Michel Boussinesq, François Labrousse, Blaise Nkegoum, Björn I Thylefors, and Charles D Mackenzie.
• National Onchocerciasis Task Force, Yaounde, Cameroon. jkamgno@yahoo.fr
• Am. J. Trop. Med. Hyg. 2008 Apr 1; 78 (4): 546-51.

AbstractDespite over 350 million people being safely treated with ivermectin, there have been rare cases of death post-treatment; these events are most often associated with high Loa loa microfilaremia. This first autopsy description of an encephalopathy case following the administration of ivermectin involves a 45-year-old male who became comatose 3 days after treatment. He slowly deteriorated over 5 weeks and died at 54 days after the anthelminthic treatment, probably as a result of a secondary skin or pulmonary infection exacerbated by malnutrition. The major pre- and post-autopsy findings included the presence of high loads of Loa loa, positivity for Plasmodium, the presence of a longstanding respiratory condition, and vascular pathology in the brain. The central nervous system lesions have similarities with those described in previously reported cases of Loa loa-associated death following diethylcarbamazine treatment.

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