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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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Transplant recipients are a population at high risk for various opportunistic infections, including toxoplasmosis. Toxoplasma infection is particularly lifethreatening in hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) recipients, primarily occurring through reactivation of latent infection or primary infection, respectively. Epidemiological, clinical features and levels of risk vary according to the transplanted organ, the pretransplant serologic status of both...
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Chagas disease is a vector-borne infection caused by the protozoan Trypanosoma cruzi that is endemic in Latin America. More recently, the geographic distribution of the disease has changed due to immigration of asymptomatic infected individuals from endemic to non-endemic regions. Therefore, Chagas disease involving acute infection among negative recipients receiving a transplant graft from positive donors and reactivation episodes among positive recipients due to posttransplant...
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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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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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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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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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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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GUIDELINES
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PARASITES AND PROTOZOA
- Chagas (2)
- Protozoa (6)
- Strongyloides (2)
- Toxoplasmosis (2)
SYNDROMES AND CONDITIONS
- Diarrhea (1)