Hong David K, Wong Cynthia J, Gutierrez Kathleen
Division of Pediatric Infectious Diseases, Department of Pediatrics, Stanford University of School of Medicine, Standford, CA 94305, USA.
Pediatr Transplant. 2007 Feb;11(1):94-100. doi: 10.1111/j.1399-3046.2006.00593.x.
Cryptosporidium is an intracellular protozoa that can cause gastroenteritis in humans. In immunocompromised hosts, infection can be severe, leading to life-threatening persistent diarrhea. There is limited experience in treating this infection in solid organ transplants. Although newer drugs active against Cryptosporidium exist, they are only licensed in the USA for treatment of immunocompetent hosts. Here we describe a seven-year-old renal transplant recipient with severe cryptosporidiosis. He had a protracted course of diarrhea of up to 2 L/day. He was successfully managed with combination antimicrobial therapy including nitazoxanide, paromomycin, and azithromycin. In conjunction with this regimen, he had a reduction in immunosuppression and complete bowel rest. His stool pattern normalized in four weeks and he has had no recurrence after six months of follow up.
隐孢子虫是一种细胞内原生动物，可导致人类患肠胃炎。在免疫功能低下的宿主中，感染可能很严重，导致危及生命的持续性腹泻。在实体器官移植中治疗这种感染的经验有限。尽管有对隐孢子虫有效的新药，但它们仅在美国被批准用于治疗免疫功能正常的宿主。在此，我们描述一名患有严重隐孢子虫病的7岁肾移植受者。他有长达每天2升的迁延性腹泻病程。通过包括硝唑尼特、巴龙霉素和阿奇霉素在内的联合抗菌治疗，他成功得到了治疗。结合该治疗方案，他减少了免疫抑制并完全禁食。他的大便模式在四周内恢复正常，随访六个月后未复发。
