Related Experiment Video

Updated: Jun 1, 2026

Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
07:06

Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection

Published on: December 8, 2014

Lessons from a transplant patient with diarrhea, cryptosporidial infection, and possible mycophenolate

P Frei1, A Weber, A Geier

  • 1Division of Gastroenterology and Hepatology, Department of Pathology, Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland. pascal.frei@usz.ch

Transplant Infectious Disease : an Official Journal of the Transplantation Society
|May 28, 2011
PubMed

Insights

Diarrhea in transplant recipients can have multiple causes. This case highlights that while mycophenolate mofetil (MMF) can cause colitis, cryptosporidial infection was the actual cause of diarrhea in this patient.

Area of Science:

  • Transplant Medicine
  • Gastroenterology
  • Infectious Diseases

Background:

  • Diarrhea is a common complication in transplant recipients, with potential causes including infection, metabolic issues, and adverse drug reactions.
  • Mycophenolate mofetil (MMF) is an immunosuppressive agent frequently implicated in causing diarrhea among transplant patients.
  • Differentiating between infectious and drug-induced diarrhea is crucial for effective management.

Observation:

  • A liver transplant recipient experienced prolonged diarrhea years post-transplantation.
  • Stool analysis revealed Cryptosporidium infection.
  • Histopathological examination of the colon showed findings consistent with MMF-induced colitis.

Findings:

  • Diarrhea resolved completely after treatment for cryptosporidial infection.
  • The patient's MMF medication was continued throughout the treatment period.
  • Despite histological evidence suggestive of MMF colitis, the diarrhea was not drug-induced.

Implications:

  • Histopathological findings suggestive of MMF colitis should not be solely relied upon to diagnose drug-induced diarrhea.
  • Infectious etiologies, such as Cryptosporidium, must be rigorously investigated in transplant recipients with diarrhea, even with concurrent MMF use.
  • This case underscores the importance of a comprehensive diagnostic approach to manage diarrhea in immunocompromised patients.

More Related Videos

Therapeutic Evaluation of Fecal Microbiota Transplantation in an Interleukin 10-Deficient Mouse Model05:41

Therapeutic Evaluation of Fecal Microbiota Transplantation in an Interleukin 10-Deficient Mouse Model

Published on: April 6, 2022

Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice08:20

Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice

Published on: July 12, 2018

Related Concept Videos

Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...
Fungal Phylum Microsporidia01:28

Fungal Phylum Microsporidia

Microsporidia are a group of obligate intracellular fungi that were initially classified as protists but were later reclassified based on phylogenetic, molecular, and structural evidence linking them to the Chytridiomycota. These unicellular, non-motile organisms are highly specialized parasites that infect a wide range of animal hosts, including humans. They have evolved extensive genomic and metabolic reductions, making them highly dependent on their hosts for survival.Morphology and Genomic...
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory Bowel Disease III: Crohn's Disease01:25

Inflammatory Bowel Disease III: Crohn's Disease

Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...