期刊
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
卷 105, 期 3, 页码 651-653出版社
AMER SOC TROP MED & HYGIENE
DOI: 10.4269/ajtmh.21-0246
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Cryptosporidial diarrhea is more common in severely immunocompromised patients, such as those with HIV/AIDS. In some cases, persistent refractory symptoms may occur even with multiple attempts at treatment.
Cryptosporidial diarrhea is uncommon in immunocompetent individuals, more often seen in severely immunocompromised patients. Severe refractory cases have been described in patients with HIV/AIDS before the advent of modern antiretroviral therapy due to an inability to mount an adequate cellular immune response. We describe an 85-year-old patient post-chimeric antigen receptor T-cell therapy relapsed lymphoma who developed refractory Cryptosporidium spp. diarrhea in the setting of persistent CD4+ cytopenia. Despite receiving multiple antiparasitic agents, including failure of a prolonged course of nitazoxanide, the patient experienced persistent symptoms for 9 months with repeatedly positivity stool Cryptosporidium spp. direct fluorescent antibody (DFA) test. We highlight this case of refractory Cryptosporidium spp. and the importance of recognizing the pathogen in a non-HIV-infected immunosuppressed host.
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