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2016 ; 6
(3
): 460-71
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Cryptosporidium infection in solid organ transplantation
#MMPMID27683627
Florescu DF
; Sandkovsky U
World J Transplant
2016[Sep]; 6
(3
): 460-71
PMID27683627
show ga
Diarrhea is a common complication in solid organ transplant (SOT) recipients and
may be attributed to immunosuppressive drugs or infectious organisms such as
bacteria, viruses or parasites. Cryptosporidium usually causes self-limited
diarrhea in immunocompetent hosts. Although it is estimated that cryptosporidium
is involved in about 12% of cases of infectious diarrhea in developing countries
and causes approximately 748000 cases each year in the United States, it is still
an under recognized and important cause of infectious diarrhea in SOT recipients.
It may run a protracted course with severe diarrhea, fluid and electrolyte
depletion and potential for organ failure. Although diagnostic methodologies have
improved significantly, allowing for fast and accurate identification of the
parasite, treatment of the disease is difficult because antiparasitic drugs have
modest activity at best. Current management includes fluid and electrolyte
replacement, reduction of immunosuppression and single therapy with Nitazoxanide
or combination therapy with Nitazoxanide and other drugs. Future drug and vaccine
development may add to the currently poor armamentarium to manage the disease.
The current review highlights key epidemiological, diagnostic and management
issues in the SOT population.