Case Report: Severe Diarrhea Caused by Cryptosporidium Diagnosed by Metagenome Next-Generation Sequencing in Blood

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Gastroenterology

Background:

• Cryptosporidium is a significant global cause of diarrhea, posing challenges in prevention and control, particularly for immunocompromised hosts.
• Cryptosporidiosis can lead to severe, life-threatening diarrhea and malabsorption in vulnerable populations, including children and transplant recipients.
• The need for rapid diagnostic tools and effective treatments for Cryptosporidium infections is critical.

Observation:

• A case of severe diarrhea in a liver transplant recipient caused by Cryptosporidium infection was reported.
• Diagnosis was confirmed using metagenomic next-generation sequencing (mNGS) and fecal microscopy.
• The patient's condition improved with adjusted immunosuppression, nitazoxanide treatment, and infection control measures.

Findings:

• Nitazoxanide remains the primary treatment for cryptosporidiosis.
• Institutional experience indicates that nitazoxanide, combined with immunosuppressant adjustment, can be effective.
• Metagenomic next-generation sequencing (mNGS) shows potential as a rapid diagnostic tool, especially in low-prevalence settings.

Implications:

• This case highlights the importance of timely diagnosis and tailored treatment strategies for cryptosporidiosis in immunocompromised patients.
• Metagenomic next-generation sequencing (mNGS) offers a promising advancement in the rapid identification of pathogens like Cryptosporidium.
• Effective management involves a multi-faceted approach including antimicrobial therapy and modulation of the host's immune status.