Oft forgotten cause of diarrhea in a posttransplant setting

Abstract

Chronic diarrhoea following a renal transplant is a common clinical manifestation. A large number of possible aetiologies complicate the diagnosis. Invasive testing is frequently conducted in patients with persistent or intractable diarrhoea. We discuss the case of a kidney transplant recipient who developed persistent diarrhoea with a 10-kg weight loss in a 3-week period. The patient was diagnosed with a Cryptosporidium parvum infection after stool screening for atypical organisms. Cryptosporidium has emerged as one of the most prevalent causes of infectious diarrhoea in post-renal transplant settings, particularly in endemic places such as India. The patient responded well to oral nitazoxanide. Post-renal transplant patients are in an immunocompromised state and are at significantly higher risk for getting infection-associated diarrhoea, so an approach for early stool screening for atypical organisms is advised.

Keywords

• cryptosporidium parvum oocyst
• cryptosporidium infection
• diarrhoea
• loss of appetite
• renal transplantation