Etiology of diarrhea in patients undergoing allogeneic bone marrow transplantation in South India1

Kang, Gagandeep; Srivastava, Alok; Pulimood, Anna; Dennison, David; Chandy, Mammen

doi:10.1097/00007890-200204270-00010

Cited by 37 publications

(32 citation statements)

References 19 publications

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“…Dehydration and electrolyte disturbances are the major sequelae of rotavirus infection and occur most often in the youngest children. Patients with immunodeficiency, including those with HIV, solid-organ or bone marrow transplantation, and natural killer cell deficiency, may have more severe or prolonged diarrhea [13][14][15][16][17]. A large study in Malawian children found no difference, however, in clinical disease between HIV-infected and noninfected patients [18].…”

Section: Rotavirus Infectionsmentioning

confidence: 99%

Acute Diarrheal Disease in Children: Epidemiology, Prevention, and Treatment

Dennehy

2005

Infectious Disease Clinics of North America

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Section: Rotavirus Infectionsmentioning

confidence: 99%

Acute Diarrheal Disease in Children: Epidemiology, Prevention, and Treatment

Dennehy

2005

Infectious Disease Clinics of North America

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“…7 NTS has been rarely reported as a cause of diarrhea in HSCT patients. 10 NTS infection, mostly bacteremia, has been reported in recipients of heart and kidney transplants. [11][12][13] The recurrence rate in our case series was low at 5.5% compared with 35% reported in renal transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

Nontyphoidal Salmonella infection among recipients of hematopoietic SCT

Dadwal

Tegtmeier

Nakamura

et al. 2010

Bone Marrow Transplant

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The incidence of nontyphoidal Salmonella (NTS) infections is rising worldwide and several outbreaks have been reported recently. Immunosuppressed patients are particularly vulnerable to NTS infections. We retrospectively examined the clinical features and outcomes of 18 recipients of hematopoietic SCT (HSCT) who were diagnosed with NTS infection at our institution during a 15-year period. Bacteremia was the most common presenting feature and occurred in 67% of cases. Diarrhea was absent in one-third of cases. Among 12 recipients of allogeneic HSCT, 8 presented with bacteremia and only 6 had diarrhea. A total of 9 of these 12 patients had chronic GVHD. Metastatic disease was distinctly rare and occurred in only two patients, whereas one patient died of NTS sepsis. Food safety practices to prevent NTS infection are important in HSCT recipients, particularly for those who have chronic GVHD after allogeneic HSCT.

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“…In the pediatric group, no significant relationship between antibiotic usage and diarrhea was seen; however, CDT positivity was influenced by antibiotics, and the relationship between CDT and fecal lactoferrin was significant [53]. Kang et al [54] reported that CDAD was more common in the post transplantation period in India than in other developed countries. Vaishnavi et al [18] reported increased prevalence of diarrhea after antibiotic usage in the ulcerative colitis group.…”

Section: Factors Precipitating Cdadmentioning

confidence: 99%

Clostridium difficile infection: clinical spectrum and approach to management

Vaishnavi

2011

Indian J Gastroenterol

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Clostridium difficile is recognized globally as an important enteric pathogen associated with considerable morbidity and mortality due to the widespread use of antibiotics. The overall incidence of C. difficile-associated diarrhea (CDAD) is increasing due to the emergence of a hypervirulent strain known as NAP1/BI/027. C. difficile acquisition by a host can result in a varied spectrum of clinical conditions inclusive of both colonic and extracolonic manifestations. Repeated occurrence of CDAD, manifested by the sudden re-appearance of diarrhea and other symptoms usually within a week of stopping treatment, makes it a difficult clinical problem. C. difficile infection has also been reported to be involved in exacerbation of inflammatory bowel diseases. The first step in the management of a suspected CDAD case is the withdrawal of the offending agent and changing the antibiotic regimens. Antimicrobial therapy directed against C. difficile viz. metronidazole for mild cases and vancomycin for severe cases is needed. For patients with ileus, oral vancomycin with simultaneous intravenous (IV) metronidazole and intracolonic vancomycin may be given. Depending on the severity of disease, the further line of management may include surgery, IV immunoglobulin treatment or high dose of vancomycin. Adjunctive measures used for CDAD are probiotics and prebiotics, fecotherapy, adsorbents and immunoglobulin therapy. Among the new therapies fidaxomicin has recently been approved by the American Food and Drugs Administration for treatment of CDAD.

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Etiology of diarrhea in patients undergoing allogeneic bone marrow transplantation in South India1

Abstract: There was significantly higher mortality (P<0.01) in patients with symptomatic or asymptomatic gastrointestinal infections caused by bacteria than in patients with parasitic or viral infections or without enteric infections.

Cited by 37 publications

References 19 publications

Acute Diarrheal Disease in Children: Epidemiology, Prevention, and Treatment

Acute Diarrheal Disease in Children: Epidemiology, Prevention, and Treatment

Nontyphoidal Salmonella infection among recipients of hematopoietic SCT

Clostridium difficile infection: clinical spectrum and approach to management

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