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Microsporidiosis in pediatric renal transplant patients in Cape Town, South Africa: Two case reports
- Source :
- Pediatric Transplantation. 18:E220-E226
- Publication Year :
- 2014
- Publisher :
- Wiley, 2014.
-
Abstract
- Microsporidia are an emerging group of pathogens associated with life-threatening opportunistic infections in immunocompromised hosts, particularly human immunodeficiency virus (HIV)-infected individuals. There have, however, been recent reports of infection in adult solid organ transplant recipients. We report two cases in children, to our knowledge the first in the paediatric literature. Two 13-yr-old, HIV-seronegative females received deceased donor renal transplants from the same donor. Both patients suffered acute cell-mediated rejection and CMV infection reactivation, managed with intensified immunosuppression and ganciclovir. Pyrexia of unknown origin and intermittent diarrhea in both prompted extensive investigations. In both patients, numerous spores of a microsporidial species were demonstrated in renal tissue on biopsy and in the urine, using modified trichrome and quick-hot Gram-chromotrope staining. Electron microscopy and PCR confirmed Encephalitozoon cuniculi infections. Both patients were successfully treated with 400 mg twice daily of albendazole, with sustained clinical improvement. We recommend that microsporidiosis be considered in the differential diagnosis of pyrexia of unknown origin in severely immunocompromised pediatric solid organ transplant recipients, particularly when associated with diarrhea.
- Subjects :
- Diarrhea
Graft Rejection
Ganciclovir
medicine.medical_specialty
Nephrotic Syndrome
Adolescent
Fever
medicine.medical_treatment
Albendazole
Microsporidiosis
South Africa
Postoperative Complications
Internal medicine
Biopsy
medicine
Humans
Renal Insufficiency
Encephalitozoon cuniculi
Transplantation
Kidney
biology
medicine.diagnostic_test
business.industry
Immunosuppression
biology.organism_classification
medicine.disease
Kidney Transplantation
medicine.anatomical_structure
Cytomegalovirus Infections
Pediatrics, Perinatology and Child Health
Immunology
Kidney Failure, Chronic
Female
medicine.symptom
business
Immunosuppressive Agents
medicine.drug
Subjects
Details
- ISSN :
- 13973142
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- Pediatric Transplantation
- Accession number :
- edsair.doi.dedup.....ac4167201505864b36619a0c0a73c3f5