Management of diarrhea in solid organ transplantation.

IF 4 3区医学 Q2 INFECTIOUS DISEASES

Current Opinion in Infectious Diseases Pub Date : 2025-10-01 Epub Date: 2025-08-13 DOI:10.1097/QCO.0000000000001144

Abdullah Alraddadi, Deepali Kumar

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引用次数: 0

Abstract

Purpose of review: Diarrhea is a common complaint in solid organ transplant recipients. We review both infectious and noninfectious causes of diarrhea and their management.

Recent findings: Diagnostics for diarrhea have now commonly incorporated multiplex gastrointestinal panels that provide rapid testing and identification of pathogens. The rate of Clostridium difficile in the transplant population has increased and fidaxomicin is now recommended as the therapy of choice for first episode and recurrences where available. Oral vancomycin remains an alternative. Norovirus is important to rule out in cases of chronic diarrhea. Nitazoxanide has shown mixed results when used as norovirus therapy. SARS-CoV-2, despite being a respiratory virus, can infect gut epithelium and present with diarrhea. Noninfectious causes especially mycophenolate-related as well as inflammatory bowel disease should be in the differential especially when no infectious cause has been identified.

Summary: A detailed history, diagnostics including molecular testing and endoscopy, and targeted therapies for infectious causes are the mainstay for management of diarrhea in the transplant recipient.

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实体器官移植中腹泻的处理。

综述目的：腹泻是实体器官移植受者的常见主诉。我们回顾感染性和非感染性腹泻的原因和他们的管理。最近的发现：腹泻的诊断现在通常包括多种胃肠道检查，提供病原体的快速检测和鉴定。移植人群中艰难梭菌的感染率有所增加，现在推荐非达索霉素作为首发和复发的首选治疗方法。口服万古霉素仍然是一种选择。在慢性腹泻病例中，重要的是要排除诺如病毒。Nitazoxanide用于诺如病毒治疗时显示出不同的结果。尽管SARS-CoV-2是一种呼吸道病毒，但它可以感染肠道上皮并表现为腹泻。非感染性原因，特别是霉酚酸相关以及炎症性肠病应在鉴别，特别是当没有感染性原因已确定。摘要：详细的病史，包括分子检测和内窥镜检查在内的诊断，以及针对感染性原因的靶向治疗是治疗移植受者腹泻的主要方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Infectious Diseases 医学-传染病学

CiteScore

6.70

自引率

2.60%

发文量

121

审稿时长

6-12 weeks

期刊介绍： This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.