Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Sep 24;6(3):460-71.
doi: 10.5500/wjt.v6.i3.460.

Cryptosporidium infection in solid organ transplantation

Diana F Florescu  1 , Uriel Sandkovsky  1
Affiliations
Review

Cryptosporidium infection in solid organ transplantation

Diana F Florescu et al. World J Transplant. .

Abstract

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.

Keywords: Antiparasitic drugs; Cryptosporidium; Diarrhea; Nitazoxanide; Solid organ transplantation.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: Dr. Diana Florescu received a grant from Chimerix Inc.; grant from CLS Behring; consulting for Chimerix Inc. and CLS Behring. Dr. Uriel Sandkovsky received a research grants from from CLS Behring, ViiV healthcare, GSK, Pfizer; consulting for Rib-X pharmaceuticals.

References

    1. Bouzid M, Hunter PR, Chalmers RM, Tyler KM. Cryptosporidium pathogenicity and virulence. Clin Microbiol Rev. 2013;26:115–134. - PMC - PubMed
    1. Chalmers RM, Davies AP. Minireview: clinical cryptosporidiosis. Exp Parasitol. 2010;124:138–146. - PubMed
    1. Bhadauria D, Goel A, Kaul A, Sharma RK, Gupta A, Ruhela V, Gupta A, Vardhan H, Prasad N. Cryptosporidium infection after renal transplantation in an endemic area. Transpl Infect Dis. 2015;17:48–55. - PubMed
    1. Krause I, Amir J, Cleper R, Dagan A, Behor J, Samra Z, Davidovits M. Cryptosporidiosis in children following solid organ transplantation. Pediatr Infect Dis J. 2012;31:1135–1138. - PubMed
    1. Bonatti H, Barroso LF, Sawyer RG, Kotton CN, Sifri CD. Cryptosporidium enteritis in solid organ transplant recipients: multicenter retrospective evaluation of 10 cases reveals an association with elevated tacrolimus concentrations. Transpl Infect Dis. 2012;14:635–648. - PubMed

LinkOut - more resources