Isospora Belli infection after isolated intestinal transplant

GRUZ FM; ; FUXMAN C; ERREA A; CABANNE A; TOKUMOTO M; FERNANDEZ A; VELASQUEZ J; NAGEL C; RUF AE; MAURIÑO E; NACHMAN F; RUMBO M; GONDOLESI GE

TRANSPLANT INFECTIOUS DISEASE

WILEY-BLACKWELL PUBLISHING, INC

Año: 2010 vol. 12 p. 69 - 72

1398-2273

Isospora belli is a protozoan that only affects humans. The parasite is aquired upon  ingestion of Isospora´s oocysts. Inmunocompetent patients usually do not develop the infection, but inmunocompromised hosts may have a profuse diarrhea with other gastrointestinal symptoms. Isospora´s treatment is based on Trimethoprim 160 mg/day sulfamethoxazole 800 mg/day.In 2006 we performed an isolated intestinal transplantation to a young man who had an ultra short gut syndrome. Neither rejection nor clinical problems occurred, although intestinal inflammation was detected on the follow-up biopsies since the first month post-transplant. Almost three months after the procedure, he was re admited with high ostomy output and clinical dehydration. In spite of having been receiving Trimethoprim / sulfamethoxazole as a protocol prophylaxis regime, an infection due to Isospora belli was diagnosed by detection of the oocysts in a stool sample. This is the first case of isosporidiasis in a small bowel recipient.The follow-up of the intestinal graft allowed us to have a detailed characterization of the evolution of the case before diagnostic and also after treatment.