CRYPTOSPORIDIUM PARVUM COLITIS IN A PEDIATRIC LIVER TRANSPLANT RECIPIENT: A CASE REPORT
Öz
Cryptosporidiosis is an opportunistic infection caused by Cryptosporidium species. It leads to severe and prolonged diarrhoea in immunosuppressed patients such as paediatric solid organ transplant recipients. We present the case of a 17-year-old male with a history of Crigler–Najjar syndrome type I who underwent living-donor liver transplantation. He was admitted with a 3-week history of vomiting and abundant watery diarrhoea. The patient was maintained on triple immunosuppressive therapy with tacrolimus, methylprednisolone, and mycophenolate mofetil. On admission, stool cultures and antigen assays for parasitic and viral pathogens, including Cryptosporidium parvum, were negative. Despite supportive treatment, his symptoms persisted, and a colonoscopic biopsy was performed. Although the mucosa appeared normal, histopathological examination revealed the presence of C. parvum. Azithromycin 500 mg was administered daily for 10 days, resulting in the rapid resolution of gastrointestinal symptoms. Early recognition and timely therapy may prevent serious complications, including rejection, biliary disease, and septic shock. This case underscores the limitations of stool antigen assays in immunosuppressed paediatric patients and highlights the diagnostic value of endoscopic biopsy in persistent diarrhoea.
Anahtar Kelimeler
Kaynakça
- Sinha R, Rahul RR. Post liver transplantation diarrhea: etiology, evaluation and treatment. Int J Med Public Health 2021;11(3):126-32 google scholar
- Fischer RT, Day JC, Wasserkrug H, Faseler M, Kats A, Daniel JF et al. Complications of Cryptosporidium infection after pediatric liver transplantation: diarrhea, rejection, and biliary disease. Pediatr Transplant 2020;24(8):e13807. google scholar
- Ahmed SAA, Quattrocchi A, Karanis P. Cryptosporidium sp. infection in solid organ transplant recipients: a systematic review and meta-analysis. Pathog Glob Health 2024;118(4):305-16. google scholar
- O’Leary JK, Sleator RD, Lucey B. Cryptosporidium spp. diagnosis and research in the 21st century. Food Waterborne Parasitol 2021;24:e00131. google scholar
- Tomczak E, McDougal AN, White AC Jr. Resolution of cryptosporidiosis in transplant recipients: review of the literature and presentation of a renal transplant patient treated with nitazoxanide, azithromycin, and rifaximin. Open Forum Infect Dis 2022;9(1):ofab610. google scholar
- Tie X, Zhang Z, Zhou R, Li Y, Xu J, Yin W. A case of septic shock due to delayed diagnosis of Cryptosporidium infection after liver transplantation. BMC Infect Dis 2023;23(1):260. google scholar
Ayrıntılar
Birincil Dil
İngilizce
Konular
Çocuk Gastroenterolojisi
Bölüm
Olgu Sunumu
Yazarlar
Aysel Majidova
0000-0002-7605-2929
Türkiye
Esma Sayar
0000-0003-2948-163X
Türkiye
Lale Alıbaylı
0000-0003-1329-6982
Türkiye
Melek Büyük
0000-0003-3425-2137
Türkiye
Zerrin Önal
0000-0002-7627-7423
Türkiye
Özlem Durmaz
0000-0001-6969-9962
Türkiye
Elif Türkmen
0000-0003-3069-2872
Türkiye
Yayımlanma Tarihi
13 Mayıs 2026
Gönderilme Tarihi
6 Kasım 2025
Kabul Tarihi
25 Mart 2026
Yayımlandığı Sayı
Yıl 2026 Cilt: 89 Sayı: 2