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Postinfectious Inflammatory Syndrome following Cryptosporidium Infection
A 38-year-old woman with a history of Crohn's disease, multiple bowel resections, and ileostomy placement presented to the hospital with symptoms of increased ileostomy output for 1 week. She reported that she was emptying her bag fifteen times a day as opposed to her normal 3–4 times a day. Up...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8436650/ https://www.ncbi.nlm.nih.gov/pubmed/34594179 http://dx.doi.org/10.1159/000515569 |
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author | Agnew, Matthew Kottapalli, Anita Kottapalli, Ven |
author_facet | Agnew, Matthew Kottapalli, Anita Kottapalli, Ven |
author_sort | Agnew, Matthew |
collection | PubMed |
description | A 38-year-old woman with a history of Crohn's disease, multiple bowel resections, and ileostomy placement presented to the hospital with symptoms of increased ileostomy output for 1 week. She reported that she was emptying her bag fifteen times a day as opposed to her normal 3–4 times a day. Upon workup, she was found to have an acute kidney injury (AKI), and stool studies were positive for Cryptosporidium. She was treated with nitazoxanide 500 mg p.o. BID for 3 days along with continued rehydration. The patient was discharged after creatinine (Cr) and electrolytes returned to baseline. She continued to have elevated ileostomy output, and 1 week later, she was readmitted for another AKI and worsening of symptoms. At this hospitalization, stool studies were negative for Cryptosporidium, and the gastroenterologist consult recommended evaluation for active Crohn's and Lomotil for possible short bowel syndrome. Eventually, her laboratory results improved, and she was discharged again before the full workup was completed. The patient's ileostomy output continued to remain high following the second hospital discharge, and she eventually returned with another AKI, her third visit in a month. The workup for active Crohn's was completed, with fecal calprotectin, serum cortisol, and small bowel follow-through all returning to normal. At this time, postinfectious inflammatory syndrome was suspected, and she was started on 60 mg of prednisone for 2 weeks. Steroid therapy elicited a significant response with normalization of her ileostomy output and return of laboratory results to baseline. The patient was discharged without return of symptoms at follow-up. |
format | Online Article Text |
id | pubmed-8436650 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-84366502021-09-29 Postinfectious Inflammatory Syndrome following Cryptosporidium Infection Agnew, Matthew Kottapalli, Anita Kottapalli, Ven Case Rep Gastroenterol Single Case A 38-year-old woman with a history of Crohn's disease, multiple bowel resections, and ileostomy placement presented to the hospital with symptoms of increased ileostomy output for 1 week. She reported that she was emptying her bag fifteen times a day as opposed to her normal 3–4 times a day. Upon workup, she was found to have an acute kidney injury (AKI), and stool studies were positive for Cryptosporidium. She was treated with nitazoxanide 500 mg p.o. BID for 3 days along with continued rehydration. The patient was discharged after creatinine (Cr) and electrolytes returned to baseline. She continued to have elevated ileostomy output, and 1 week later, she was readmitted for another AKI and worsening of symptoms. At this hospitalization, stool studies were negative for Cryptosporidium, and the gastroenterologist consult recommended evaluation for active Crohn's and Lomotil for possible short bowel syndrome. Eventually, her laboratory results improved, and she was discharged again before the full workup was completed. The patient's ileostomy output continued to remain high following the second hospital discharge, and she eventually returned with another AKI, her third visit in a month. The workup for active Crohn's was completed, with fecal calprotectin, serum cortisol, and small bowel follow-through all returning to normal. At this time, postinfectious inflammatory syndrome was suspected, and she was started on 60 mg of prednisone for 2 weeks. Steroid therapy elicited a significant response with normalization of her ileostomy output and return of laboratory results to baseline. The patient was discharged without return of symptoms at follow-up. S. Karger AG 2021-08-25 /pmc/articles/PMC8436650/ /pubmed/34594179 http://dx.doi.org/10.1159/000515569 Text en Copyright © 2021 by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission. |
spellingShingle | Single Case Agnew, Matthew Kottapalli, Anita Kottapalli, Ven Postinfectious Inflammatory Syndrome following Cryptosporidium Infection |
title | Postinfectious Inflammatory Syndrome following Cryptosporidium Infection |
title_full | Postinfectious Inflammatory Syndrome following Cryptosporidium Infection |
title_fullStr | Postinfectious Inflammatory Syndrome following Cryptosporidium Infection |
title_full_unstemmed | Postinfectious Inflammatory Syndrome following Cryptosporidium Infection |
title_short | Postinfectious Inflammatory Syndrome following Cryptosporidium Infection |
title_sort | postinfectious inflammatory syndrome following cryptosporidium infection |
topic | Single Case |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8436650/ https://www.ncbi.nlm.nih.gov/pubmed/34594179 http://dx.doi.org/10.1159/000515569 |
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