A case of hepato-biliary infection secondary to cryptosporidium in a patient on tacrolimus

Sajal Gupta; Alison Johnson; Simon Meyrick; Angharad P. Davies; R. Chalmers

doi:10.1099/jmmcr.0.005159

Volume 5, Issue 8

Case Report

Open Access

A case of hepato-biliary infection secondary to cryptosporidium in a patient on tacrolimus

Sajal Gupta¹, Alison Johnson¹, Simon Meyrick¹, Angharad P. Davies² and R. Chalmers²
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Affiliations: ¹ 1Wye Valley NHS Trust, The County Hospital, Union Walk, Hereford, Herefordshire, HR1 2ER, UK ² 2Cryptosporidium Reference Unit, Public Health Wales Microbiology ABM, Singleton Hospital, Sgeti, Swansea, SA2 8QA, UK
*Correspondence: Alison Johnson [email protected]
Published: 20 July 2018 https://doi.org/10.1099/jmmcr.0.005159

Abstract

Introduction. Cryptosporidium infection is known to cause hepato-biliary involvement, mainly in association with T-cell immune deficiency. Hepato-biliary involvement in association with milder immunosuppression is less well described. We describe the first case, to our knowledge, of Cryptosporidium hominis hepato-biliary infection associated with tacrolimus in a patient with nephrotic syndrome.

Case presentation. A 14 year old girl who had been on tacrolimus for nephrotic syndrome presented with diarrhea due to C. hominis. Nineteen days after her initial presentation she attended hospital with abdominal pain and deranged liver function tests. An ultrasound scan showed a thickened gall bladder. Her symptoms settled and her liver function tests returned to normal after treatment with nitazoxanide.

Conclusion. Cryptosporidium should be considered in the differential diagnosis of both diarrhea and hepato-biliary symptoms and abnormal liver function tests, even in the presence of relatively mild immunosuppression. Nitazoxanide was an effective treatment in this case.

Received: 01/03/2018
Accepted: 18/06/2018
Published Online: 20/07/2018

Keyword(s): cryptosporidium , hepato-biliary , nitazoxanide and tacrolimus

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Volume 5, Issue 8

Case Report

Open Access

A case of hepato-biliary infection secondary to cryptosporidium in a patient on tacrolimus

Abstract

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