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Babesiosis is likely to become a more frequent infectious complication in immunosuppressed hosts as the areas of endemicity expand. Reduced efficacy of standard therapies is likely to continue emerging so more effort needs to be placed on methods of assessing resistance in vitro and developing more reliable treatments for resistant infections.
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We report Babesia microti genomic sequences with multiple mutations in the atovaquone-target region of cytochrome b, including a newly identified Y272S mutation, plus 1 mutation of undetermined significance in the azithromycin-associated ribosomal protein L4. The parasite was sequenced from an immunocompromised patient on prophylactic atovaquone for Pneumocystis pneumonia before diagnosis of babesiosis.
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Background. Cryptosporidium is a major cause of diarrheal disease worldwide, including chronic disease in malnourished children and patients with acquired immune deficiency syndrome. There are increasing reports of cryptosporidiosis in transplant patients, especially from middle-income countries. Methods. The literature on treatment of cryptosporidiosis in transplant patients was reviewed and included no controlled trials but only small case series. Nitazoxanide, azithromycin, spiramycin,...
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Crypto and Cryptosporidium Infection fact sheets for Immunocompromised Persons
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Leishmaniasis is a rare disease in both solid-organ and hematopoietic stem cell transplantation. Additionally, the frequency of disease is likely related to the leishmaniasis prevalence in the general population. Although cutaneous leishmaniasis (CL) presentation is more prevalent than that of visceral leishmaniasis (VL) in the general population, the opposite occurs in transplant patients. The current available knowledge is based on small series, case reports, or extrapolations from studies...
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Cases of malaria infection have been reported in solid organ and hematopoietic stem cell transplantation; malaria infections may occur as a consequence of a donor-derived infection (from organ or blood), as a relapse of previous P. vivax or P. ovale infection, or as newly acquired infections after transplantation in endemic areas. In donors or candidates with epidemiological risk of malaria infection, sensitive techniques in laboratory surveillance, including molecular tests, to rule out...
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Free-living amoebae (FLA) are ubiquitous in the environment. Although they rarely cause infection in humans, when they do so, the infection is often severe and diagnosed late. The three most clinically relevant genera of FLA are Acanthamoeba spp., Naegleria fowleri, and Balamuthia mandrillaris. An increasing body of literature points to these organisms as potential diseasecausing agents in immunocompromised and transplant patients, particularly with regard to donor-derived infections. This...
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Although a less common cause of gastrointestinal illness in transplant recipients than bacterial or viral etiologies, intestinal parasitic infections can result in severe and prolonged disease in this population. In the developed world, diagnostic delays stemming from low clinical suspicion for intestinal parasites (and the limitations of standard diagnostics) can worsen outcomes in these patients. As travel becomes more frequent among patients both before and after transplant, and with the...
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Background Cryptosporidium enteritis can be devastating in the immunocompromised host. In pediatric liver transplant recipients, infection may be complicated by prolonged carriage of the parasite, rejection, and biliary tree damage and fibrosis. Herein, we report on six patients and their long-term outcomes following cryptosporidiosis. Methods We reviewed all cases of cryptosporidiosis in a pediatric liver transplant population over a 17-year period at a single center. Six patients with...
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These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of intestinal parasites in the pre- and post-transplant period. Intestinal parasites are prevalent in the developing regions of the world. With increasing travel to and from endemic regions, changing immigration patterns, and the expansion of transplant medicine in developing countries, they are increasingly recognized as a...
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These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of tissue and blood protozoal infections in the pre- and post-transplant period. Significant new developments in the field have made it necessary to divide the previous single guideline published in 2013 into two sections, with the intestinal parasites separated from this guideline devoted to tissue and blood protozoa. The...
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