title: Multiple parasitic infections in a cardiac transplant recipient.
abstract: Infectious complications represent an important cause of morbidity and death in patients with transplant. Parasitic infections are less frequent than viral and bacterial agents, and are often overlooked. We describe the case of a 13-year-old adolescent, born in São Tomé Island, who was under immunosuppressive therapy after a cardiac transplant. The patient had an intermittent course of diarrhoea, abdominal pain and vomiting. She was admitted dehydrated, and Strongyloides stercoralis, Schistosoma intercalatum and Cystoisospora belli were isolated in her stools. The patient was treated with ivermectin, albendazole, praziquantel and ciprofloxacin with clinical and microbiological resolution. Her immunosuppressive therapy was reduced during hospitalisation. We believe that the parasitic infection was a result of a recrudescence of dormant infections acquired in her homeland. To the best of our knowledge, there are no reports of cystoisosporiasis or schistosomiasis in heart transplant recipients.
authors.affiliation: Department of Pediatrics, Hospital Garcia de Orta, Almada, Portugal.
authors.forename: Bruno Fernandes
authors.initials: BF
authors.lastname: Sanches
authors.affiliation: Department of Pediatrics, Hospital Espírito Santo, Évora, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Morgado
authors.affiliation: Department of Pediatric Cardiology, Hospital Santa Cruz, Lisbon, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Carvalho
authors.affiliation: Department of Pediatric Cardiology, Hospital Santa Cruz, Lisbon, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Anjos
mesh_terms: D015746:Abdominal Pain / Q000469:parasitology*; D000293:Adolescent; D015766:Albendazole / Q000008:administration & dosage; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage; D003967:Diarrhea / Q000150:complications / Q000469:parasitology*; D005243:Feces / Q000469:parasitology; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage; D011223:Praziquantel / Q000008:administration & dosage; D012547:Schistosoma / Q000302:isolation & purification*; D012552:Schistosomiasis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D017171:Strongyloides stercoralis / Q000302:isolation & purification*; D013322:Strongyloidiasis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D066027:Transplant Recipients; D016896:Treatment Outcome; D014839:Vomiting / Q000469:parasitology
chemical_list: D000871:Anthelmintics; D011223:Praziquantel; D007559:Ivermectin; D015766:Albendazole