title: Norovirus gastroenteritis successfully treated with nitazoxanide.
abstract: Infectious diarrhea is a common occurrence in the immunosuppressed population. We present a 43-year-old individual with large-volume stool output Norovirus acute gastroenteritis in the setting of relapsed refractory acute myelogenous leukemia, hematopoietic stem cell transplantation, and biopsy-proven cutaneous and pulmonary graft-versus-host disease. Therapeutic options such as intravenous immunoglobulin or reduction of immunosuppressants were not a feasible choice. A prompt clinical cure was achieved with nitazoxanide, a broad-spectrum antimicrobial agent. Nitazoxanide may be a safe therapeutic alternative, in which a reduction in immunosuppression may not be a viable option.
authors.affiliation: Department of Medicine, Division of Infectious Disease, Baylor College of Medicine, United States.
authors.forename: Danish M
authors.initials: DM
authors.lastname: Siddiq
authors.forename: Hoonmo L
authors.initials: HL
authors.lastname: Koo
authors.forename: Javier A
authors.initials: JA
authors.lastname: Adachi
authors.forename: George M
authors.initials: GM
authors.lastname: Viola
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D017250:Caliciviridae Infections / Q000188:drug therapy* / Q000821:virology; D003937:Diagnosis, Differential; D005243:Feces / Q000821:virology; D005759:Gastroenteritis / Q000188:drug therapy* / Q000821:virology; D006086:Graft vs Host Disease / Q000150:complications; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007165:Immunosuppression Therapy; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000628:therapy; D008297:Male; D009574:Nitro Compounds; D029322:Norovirus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013844:Thiazoles / Q000627:therapeutic use*
chemical_list: D000890:Anti-Infective Agents; D009574:Nitro Compounds; D013844:Thiazoles; C041747:nitazoxanide