Acute diarrhea in solid organ transplant patients

What are the common causes of acute diarrheal illness among solid organ transplant patients? 

Valganciclovir use has resulted in less CMV-related disease. Community viral pathogens, in particular Norovirus, are more common. In the setting of colitis, CMV remains the most common etiologic factor. CMV presence on biopsy polymerase chain reaction (PCR) does not always correlate to causative agent when on suppressive antiviral therapy and tissue evidence of CMV disease (histopathologic) is desirable. 

Parasitic infection rates in organ transplant recipients are not entirely known and are more common in developing countries. Clues of infection may be bronchopneumonia, prolonged fever, and meningitis. Pathways to infection include de novo, reactivation of latent infection, or transmission from the graft.

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