Case Report: Diagnosis of Cryptosporidiosis in Renal Transplantation in a Low-Prevalence Setting

Abstract

In high prevalence settings, cryptosporidiosis is commonly implicated as a cause of a gastroenteritis syndrome in the organ transplant population. Stool microscopy is predominant diagnostic modality. Therapeutic options in this group of patients are limited, making their management exceptionally challenging. We describe a case of a renal transplant recipient with cryptosporidiosis confirmed by the stool FilmArray gastrointestinal panel (GIP) nucleic acidbased assay and stool microscopy, describe our institutional experience in diagnosing cryptosporidiosis in a lowprevalence setting, and review the available literature on management of this condition in the organ transplant population. In a low-prevalence setting, the GIP can serve as a rapid screening tool in the diagnosis of cryptosporidiosis.

Successful management of life-threatening post-COVID-19 cryptosporidiosis in a renal transplant patient: a case report

“…including Cryptosporidium hominis and Cryptosporidium parvum . The extremely rare species of Cryptosporidium xiaoi, Cryptosporidium ryanae , and bovis are not picked up by it [ 5 ]. Despite being examined with only 18 positive clinical specimens, GIP's sensitivity and specificity for identifying cryptosporidiosis were 100% and 99.6%, respectively, in one of the biggest multicenter evaluations.…”

Cryptosporidiosis in HIV-seronegative patients: A case series

“…Stool FilmArray gastrointestinal panel (GIP) is also increasingly becoming popular owing to its quick turnaround time. 3 ICT has a disadvantage of detecting only C.parvum antigens and ELISA results need to be confirmed by mZN staining. In light of the above, microscopy continues to be the preferred method of diagnosis in low prevalence areas owing to its good sensitivity and specificity than other rapid diagnostic methods.…”

“…Diagnosis of the disease in the susceptible population is dependent on having a high index of suspicion especially in low-prevalence areas as routine stool sampling for ova, cysts, and parasites is not diagnostic. 3 Cryptosporidiosis is usually transmitted by poor sanitary conditions with low levels of personal hygiene and by ingestion of water tainted with human waste. Centers for Disease Control and Prevention (CDC) reports have shown that outbreaks due to this organism have increased even in the developed countries such as the United States owing to contamination of recreational and municipal water supplies.…”

Resolution of Cryptosporidiosis in Transplant Recipients: Review of the Literature and Presentation of a Renal Transplant Patient Treated With Nitazoxanide, Azithromycin, and Rifaximin

“…Acid-fast staining, which has been used to detect cryptosporidiosis, is thought to miss many cases [ 10 , 29 ]. In recent years, increased use of antigen-detection assays and nucleic acid amplification are revealing more cases [ 29 , 30 ].…”