Rare diseases with chronic diarrhea



Vibrio parahaemolyticus usually causes a self-limiting acute diarrheal illness, and is rarely tested for in cases of chronic diarrhea. We present a rare case of chronic diarrhea caused by V. parahaemolyticus in a heart transplant patient requiring antibiotic treatment.


Chronic diarrhea is a common problem in immunocompromised patients. The most frequently encountered etiologies include infections, graft-versus-host disease, and immunosuppressive drugs. Among infections, Cytomegalovirus (CMV) and Clostridium difficile are the most common causes of diarrhea. A less frequent cause, Vibrio, usually triggers an acute diarrheal illness, and only 1 prior case of prolonged diarrhea caused by this organism has been reported.1

Case Report

A 66-year-old man with an orthotopic heart transplant 7 years prior to admission presented with 3 months of 4-5 episodes of watery diarrhea per day while taking cyclosporine and mycophenolate mofetil. He reported a 7-pound weight loss, but denied fevers, chills, anorexia, vomiting, or abdominal pain. He had no sick contacts or recent travel. Of note, he had a history of similar loose stools a few years prior, secondary to chronic norovirus infection, that improved with supportive management and reduction in the dose of mycophenolate mofetil.

He was initially managed with a reduction and then cessation of mycophenolate mofetil without resolution of symptoms. Graft function and cyclosporine levels were normal. White blood cell count, thyroid indices, inflammatory markers, and liver function tests were all within normal limits. Stool specimens were watery with no blood and very little mucus; microscopy revealed fecal leukocytes. No ova or parasites were seen, and stool cultures were negative. Tests for Giardia, Yersinia, Epstein-Barr virus, rotavirus, norovirus, CMV, C. difficile, Cryptosporidia, Isospora, and Cyclospora were negative. Tissue transglutaminase and endomysial IgA and IgG were within normal limits. A fecal fat-stain was normal. Upper endoscopy and colonoscopy were unremarkable. Random gastric, duodenal, and colonic biopsies were normal.

You might also like
Can Irritable Bowel Syndrome Cause Nausea?
Can Irritable Bowel Syndrome Cause Nausea?
Function of Cancer Gene Discovered, Genetic Cause of Rare
Function of Cancer Gene Discovered, Genetic Cause of Rare ...
Antrodia Cinnamomea Liquid Pure Extract - 25 g/L of polysaccharides per serving - SGS Certified, cGMP Certified, Guaranteed Authentic, 99.6% rDNA Proven Genuine - 30 bottles, 20ml per bottle - Made in Taiwan.
Health and Beauty (CGB Corp.)
  • Antrodia cinnamomea, formerly named Antrodia camphorata, is a rare medicinal mushroom well-known for its effects on a number of health conditions. Its rich composition...
  • Antrodia cinnamomea is only found in Taiwan s endangered tree, Cinnamomum kanehirai, at altitudes of 450-2 meters in low-elevation mountainous terrain. This specific...
  • Proven through molecular identification, our Antrodia Cinnamomea has a 99.6% similarity in rDNA sequence compared to the wild-type strain grown in Taiwan, listed...
  • You Deserve Safety & Quality: Safe and all natural products. No chemicals, preservatives or additives in any offering! CGB s State-of-the-art Research Center...
  • MADE IN TAIWAN (NOT CHINA) Repeatedly named a top 3 most trusted and recognized brand by Business Today Taiwan, Chang Gung Biotechnology Corp s has over 90 health...

Dragsbaek: 5 public health threats scarier than Ebola  — Longview News-Journal
Children died not from a rare infectious disease but from a vaccine-preventable disease that we didn't protect them from. 2. Pertussis: In 2013, Texas reported 3,985 cases of pertussis, or whooping cough — more than any other state in the U.S.

Popular Q&A

What disease can cause nausea, headaches, and excessive fever?

The flu causes nausea, headaches and high fever. If symptoms continue or you have other health problems see a doctor. !

Related Posts