Eradication of cryptosporidium from a defunctionalized colon limb by refeeding stoma effluent Journal Article
| Authors: | Sidebotham, E. L.; Sepkowitz, K.; Price, A. P.; Steinherz, P. G.; La Quaglia, M. P.; Kayton, M. L. |
| Article Title: | Eradication of cryptosporidium from a defunctionalized colon limb by refeeding stoma effluent |
| Abstract: | Over the last 40 years, cryptosporidium has increasingly been recognized as a cause of acute self-limiting diarrhea in normal hosts. In the immunocompromised patient, cryptosporidium may cause severe illness with prolonged diarrhea and malabsorption. Pharmacologic therapy of cryptosporidium relies on adequate delivery of drug metabolites to the colon. Here we describe a patient who developed toxic megacolon during induction therapy for leukemia, requiring ileostomy formation to proceed with leukemia treatment. Although the megacolon resolved promptly, the resulting isolation of the colon from the fecal stream prevented luminal delivery of active metabolites of anti-protozoal drugs, resulting in persistent cryptosporidiosis. Refeeding of the ileostomy output into the colon effectively eradicated cryptosporidium from the colon and permitted closure of the ileostomy. © 2010 Elsevier Inc. All rights reserved. |
| Keywords: | child; treatment outcome; child, preschool; leukemia; leukemia, myeloid, acute; case report; diarrhea; cytarabine; animals; multiple cycle treatment; etoposide; antineoplastic combined chemotherapy protocols; dexamethasone; antiprotozoal agent; antiprotozoal agents; anti-bacterial agents; drug therapy, combination; stoma; ileostomy; daunorubicin; acute myeloblastic leukemia; catheterization; azithromycin; feces; colon; immunosuppression; cryptosporidiosis; eradication therapy; cryptosporidium; megacolon; trichuris; nitazoxanide; bloody diarrhea; effluent; toxic megacolon; colonic diseases |
| Journal Title: | Journal of Pediatric Surgery |
| Volume: | 45 |
| Issue: | 1 |
| ISSN: | 0022-3468 |
| Publisher: | W.B. Saunders Co-Elsevier Inc. |
| Date Published: | 2010-01-01 |
| Start Page: | e33 |
| End Page: | e36 |
| Language: | English |
| DOI: | 10.1016/j.jpedsurg.2009.10.091 |
| PUBMED: | 20105571 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Export Date: 20 April 2011" - "CODEN: JPDSA" - "Source: Scopus" |
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53Price -
411La Quaglia -
272Sepkowitz -
19Kayton -
221Steinherz
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