Emerging of Fatal Colitis with Multidrug-Resistant Candida glabrata after Small Bowel Transplantation
Background. Small bowel transplantation is a potential option for patients with intestinal-failure, and the incidences of infections caused by Candida species that are more resistant to antifungal drugs are increasing in these patients. In this manuscript, we reported a case of fatal colitis after s...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2021/9995583 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832561605316968448 |
|---|---|
| author | Zahra Zareshahrabadi Mojtaba Shafiekhani Hamed Nikoupour Hasti Nouraei Hamid Morovati Kamiar Zomorodian |
| author_facet | Zahra Zareshahrabadi Mojtaba Shafiekhani Hamed Nikoupour Hasti Nouraei Hamid Morovati Kamiar Zomorodian |
| author_sort | Zahra Zareshahrabadi |
| collection | DOAJ |
| description | Background. Small bowel transplantation is a potential option for patients with intestinal-failure, and the incidences of infections caused by Candida species that are more resistant to antifungal drugs are increasing in these patients. In this manuscript, we reported a case of fatal colitis after small bowel transplantation induces by multidrug-resistant (MDR) Candida glabrata. Case Presentation. A 52-year-old man has undergone an extensive small bowel resection with the length of the remaining bowel which was less than 40 cm who became a candidate for transplantation. Four months after transplantation, the patient experienced severe bloody diarrhea with abdominal distension. Ileoscopy and colonoscopy did not show neither pathological change and rejection nor cytomegalovirus (CMV) infection posttransplantation. Abdomen computed tomography showed diffuse moderate small bowel wall thickening. After detection of budding yeast in the stool samples, stool culture was positive for Candida, DNA was extracted, and ITS1-5.8s-ITS2 region of the fungal agent was amplified. Sequencing analysis of PCR and antifungal susceptibility testing revealed that this isolate was multidrug-resistant C. glabrata. Besides, there was no evidence for other pathogens known to cause infection in various laboratory tests. Immediate antifungal treatments with caspofungin remained unsuccessful, and on the eighteenth day of admission, the patient expires with septic shock. Conclusion. These findings highlight the challenging management of candidiasis in patients with small bowel transplantation. Infectious diseases due to MDR organisms have emerged as a vital clinical problem in this patient population. |
| format | Article |
| id | doaj-art-f596ddcd816949a79487ce75ffc492f7 |
| institution | Kabale University |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-f596ddcd816949a79487ce75ffc492f72025-02-03T01:24:43ZengWileyCase Reports in Transplantation2090-69432090-69512021-01-01202110.1155/2021/99955839995583Emerging of Fatal Colitis with Multidrug-Resistant Candida glabrata after Small Bowel TransplantationZahra Zareshahrabadi0Mojtaba Shafiekhani1Hamed Nikoupour2Hasti Nouraei3Hamid Morovati4Kamiar Zomorodian5Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranShiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, IranShiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranBackground. Small bowel transplantation is a potential option for patients with intestinal-failure, and the incidences of infections caused by Candida species that are more resistant to antifungal drugs are increasing in these patients. In this manuscript, we reported a case of fatal colitis after small bowel transplantation induces by multidrug-resistant (MDR) Candida glabrata. Case Presentation. A 52-year-old man has undergone an extensive small bowel resection with the length of the remaining bowel which was less than 40 cm who became a candidate for transplantation. Four months after transplantation, the patient experienced severe bloody diarrhea with abdominal distension. Ileoscopy and colonoscopy did not show neither pathological change and rejection nor cytomegalovirus (CMV) infection posttransplantation. Abdomen computed tomography showed diffuse moderate small bowel wall thickening. After detection of budding yeast in the stool samples, stool culture was positive for Candida, DNA was extracted, and ITS1-5.8s-ITS2 region of the fungal agent was amplified. Sequencing analysis of PCR and antifungal susceptibility testing revealed that this isolate was multidrug-resistant C. glabrata. Besides, there was no evidence for other pathogens known to cause infection in various laboratory tests. Immediate antifungal treatments with caspofungin remained unsuccessful, and on the eighteenth day of admission, the patient expires with septic shock. Conclusion. These findings highlight the challenging management of candidiasis in patients with small bowel transplantation. Infectious diseases due to MDR organisms have emerged as a vital clinical problem in this patient population.http://dx.doi.org/10.1155/2021/9995583 |
| spellingShingle | Zahra Zareshahrabadi Mojtaba Shafiekhani Hamed Nikoupour Hasti Nouraei Hamid Morovati Kamiar Zomorodian Emerging of Fatal Colitis with Multidrug-Resistant Candida glabrata after Small Bowel Transplantation Case Reports in Transplantation |
| title | Emerging of Fatal Colitis with Multidrug-Resistant Candida glabrata after Small Bowel Transplantation |
| title_full | Emerging of Fatal Colitis with Multidrug-Resistant Candida glabrata after Small Bowel Transplantation |
| title_fullStr | Emerging of Fatal Colitis with Multidrug-Resistant Candida glabrata after Small Bowel Transplantation |
| title_full_unstemmed | Emerging of Fatal Colitis with Multidrug-Resistant Candida glabrata after Small Bowel Transplantation |
| title_short | Emerging of Fatal Colitis with Multidrug-Resistant Candida glabrata after Small Bowel Transplantation |
| title_sort | emerging of fatal colitis with multidrug resistant candida glabrata after small bowel transplantation |
| url | http://dx.doi.org/10.1155/2021/9995583 |
| work_keys_str_mv | AT zahrazareshahrabadi emergingoffatalcolitiswithmultidrugresistantcandidaglabrataaftersmallboweltransplantation AT mojtabashafiekhani emergingoffatalcolitiswithmultidrugresistantcandidaglabrataaftersmallboweltransplantation AT hamednikoupour emergingoffatalcolitiswithmultidrugresistantcandidaglabrataaftersmallboweltransplantation AT hastinouraei emergingoffatalcolitiswithmultidrugresistantcandidaglabrataaftersmallboweltransplantation AT hamidmorovati emergingoffatalcolitiswithmultidrugresistantcandidaglabrataaftersmallboweltransplantation AT kamiarzomorodian emergingoffatalcolitiswithmultidrugresistantcandidaglabrataaftersmallboweltransplantation |