ESPN 51th Annual Meeting

ESPN 2018


 
Intestinal Parasitosis in Children Fallowing Renal Transplantation
EREN SOYALTIN 1 NEVİN TURGAY 3 ÖNDER YAVAŞCAN 1 CANER ALPARSLAN 1 BELDE KASAP DEMIR 2 DEMET ALAYGUT 1 SEÇIL ARSLANSOYU ÇAMLAR 1 FATMA MUTLUBAŞ 1

1- IZMIR TEPECIK TRAINING AND RESEARCH HOSPITAL DEPARTMENT OF PEDIATRICS DIVISION OF NEPHROLOGY, IZMIR, TURKEY
2- IZMIR KATIP ÇELEBI UNIVERSITY DEPARTMENT OF PEDIATRICS DIVISION OF NEPHROLOGY, IZMIR, TURKEY
3- EGE UNIVERSITY MEDICAL FACULTY DEPARTMENT OF PARASITOLOGY IZMIR
 
Introduction:

Opportunistic parasitic infections could be lead to gastrointestinal infections with symptoms such as diarrhea, abdominal pain and vomiting, and acute graft failure (AGD) secondary to life-threatening dehydration in immuncompromise cases such as kidney transplant (KTx) donors.

Material and methods:

Children with KTx in our clinic were retrospectively evaluated for opportunistic parasitic infections from January 2016 to January 2018. Clinical, laboratory characteristics, admission symptoms and type of parasites were analyzed. AGD was defined as a 25% increase in creatinine level relative to baseline. The parasitological examination of stool was carried out using the Ziehl-Neelsen method.

Results:

Parasitosis was detected in 7 (11.4%) of the 61 cases with KTx in the median 5 (mean: 5.42 ± 3.95) years of follow-up period. When the complaints of the cases were examined, 6 recurrent abdominal pain and diarrhea episodes were detected, 4 cases had admitted with vomiting and 2 with malnutrition. In all cases with parasitosis, AGD was detected secondary to dehydration. In 4 cases Cyriptosporidium spp., in 1 Cyriptosporidium spp., and Cyclospora, in 1 Giardia intestinalis, and in 1 Cyriptosporidium spp., Giardia and Blastocysts were detected concurrently. Azithromycin (10 mg/kg/day) and Metronidazole (30 mg/kg/day) were administered orally to all cases for 14 days. In all cases clinical findings were delayed within 1-2 weeks and graft functions returned to normal values. However within 5 months (71.4%) the clinical findings were reproduced. The same treatment had to be applied upon the detection of parasite isolation in the stool.  

Conclusions:

The early recognition of opportunistic parasitic infections in children with KTx and gastrointestinal symptoms is important for the treatment and prevention of AGD and complications due to fluid and electrolyte imbalance.