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Gastrointestinal infections in solid organ transplant recipients

Purpose of reviewThe population of immunosupressed individuals in the world is increasing every year. Solid organ transplant recipients continue to increase at a steady rate, and with each year, new information on unusual clinical presentations of bacterial, viral, and fungal pathogens emerge. The significant morbidity and mortality from undiagnosed gastrointestinal infections in the solid organ transplant recipient makes it important to diagnose early and understand that many of these pathogens require special methods for detection and isolation. Recent findingsThis review examines the published reports of gastrointestinal infections in solid organ transplant recipients in the past year. Cytomegalovirus infection continues to be an important gastrointestinal pathogen. Gastrointestinal CMV disease has been associated with biliary complications, ischemic colitis, and colocutaneous fistulae after solid organ transplantation. Detection on CMV utilizing qualitative polymerase chain reaction of upper gastrointestinal tract biopsy material has shown to be an accurate method for the detection of CMV. Adenovirus and calicivirus are significant intestinal pathogens after intestinal transplantation and necessitates early diagnosis and treatment. Bacterial pathogens such as Clostridium difficile, Listeria monocytogenes, and Vibrio parahaemolyticus, as well as the fungal pathogen Cryptococcus neoformans, can all present with unusual gastrointestinal symptoms. SummaryAs the number and type of solid organ transplant recipients continues to increase every year, newer pathogens will continue to emerge, as well as more unusual clinical presentations of more established pathogens. Appropriate and timely diagnosis of gastrointestinal tract infection in solid organ transplant recipients is particularly challenging as many symptoms mimic less morbid conditions, infected tissue is not readily accessible for analysis, and many of these pathogens require special processing for diagnosis.