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A case of hepato-biliary infection secondary to cryptosporidium in a patient on tacrolimus

INTRODUCTION. Cryptosporidium infection is known to cause hepato-biliary involvement, mainly in association with T-cell immune deficiency. Hepato-biliary involvement in association with milder immunosuppression is less well described. We describe the first case, to our knowledge, of Cryptosporidium...

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Autores principales: Gupta, Sajal, Johnson, Alison, Meyrick, Simon, Davies, Angharad P., Chalmers, R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Microbiology Society 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152403/
https://www.ncbi.nlm.nih.gov/pubmed/30323935
http://dx.doi.org/10.1099/jmmcr.0.005159
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author Gupta, Sajal
Johnson, Alison
Meyrick, Simon
Davies, Angharad P.
Chalmers, R.
author_facet Gupta, Sajal
Johnson, Alison
Meyrick, Simon
Davies, Angharad P.
Chalmers, R.
author_sort Gupta, Sajal
collection PubMed
description INTRODUCTION. Cryptosporidium infection is known to cause hepato-biliary involvement, mainly in association with T-cell immune deficiency. Hepato-biliary involvement in association with milder immunosuppression is less well described. We describe the first case, to our knowledge, of Cryptosporidium hominis hepato-biliary infection associated with tacrolimus in a patient with nephrotic syndrome. CASE PRESENTATION. A 14 year old girl who had been on tacrolimus for nephrotic syndrome presented with diarrhea due to C. hominis. Nineteen days after her initial presentation she attended hospital with abdominal pain and deranged liver function tests. An ultrasound scan showed a thickened gall bladder. Her symptoms settled and her liver function tests returned to normal after treatment with nitazoxanide. CONCLUSION. Cryptosporidium should be considered in the differential diagnosis of both diarrhea and hepato-biliary symptoms and abnormal liver function tests, even in the presence of relatively mild immunosuppression. Nitazoxanide was an effective treatment in this case.
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spelling pubmed-61524032018-10-15 A case of hepato-biliary infection secondary to cryptosporidium in a patient on tacrolimus Gupta, Sajal Johnson, Alison Meyrick, Simon Davies, Angharad P. Chalmers, R. JMM Case Rep Case Report INTRODUCTION. Cryptosporidium infection is known to cause hepato-biliary involvement, mainly in association with T-cell immune deficiency. Hepato-biliary involvement in association with milder immunosuppression is less well described. We describe the first case, to our knowledge, of Cryptosporidium hominis hepato-biliary infection associated with tacrolimus in a patient with nephrotic syndrome. CASE PRESENTATION. A 14 year old girl who had been on tacrolimus for nephrotic syndrome presented with diarrhea due to C. hominis. Nineteen days after her initial presentation she attended hospital with abdominal pain and deranged liver function tests. An ultrasound scan showed a thickened gall bladder. Her symptoms settled and her liver function tests returned to normal after treatment with nitazoxanide. CONCLUSION. Cryptosporidium should be considered in the differential diagnosis of both diarrhea and hepato-biliary symptoms and abnormal liver function tests, even in the presence of relatively mild immunosuppression. Nitazoxanide was an effective treatment in this case. Microbiology Society 2018-07-20 /pmc/articles/PMC6152403/ /pubmed/30323935 http://dx.doi.org/10.1099/jmmcr.0.005159 Text en © 2018 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Gupta, Sajal
Johnson, Alison
Meyrick, Simon
Davies, Angharad P.
Chalmers, R.
A case of hepato-biliary infection secondary to cryptosporidium in a patient on tacrolimus
title A case of hepato-biliary infection secondary to cryptosporidium in a patient on tacrolimus
title_full A case of hepato-biliary infection secondary to cryptosporidium in a patient on tacrolimus
title_fullStr A case of hepato-biliary infection secondary to cryptosporidium in a patient on tacrolimus
title_full_unstemmed A case of hepato-biliary infection secondary to cryptosporidium in a patient on tacrolimus
title_short A case of hepato-biliary infection secondary to cryptosporidium in a patient on tacrolimus
title_sort case of hepato-biliary infection secondary to cryptosporidium in a patient on tacrolimus
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152403/
https://www.ncbi.nlm.nih.gov/pubmed/30323935
http://dx.doi.org/10.1099/jmmcr.0.005159
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