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CC BY-NC-ND 4.0 · Journal of Gastrointestinal Infections 2025; 15(01/02): 26-29
DOI: 10.1055/s-0045-1811653
Brief Report

Sapovirus as an Emerging Pathogen Implicated in Chronic Diarrhea in Post-Solid Organ Transplant Setting: A Brief Report

Authors

  • Anshuman Elhence

    1   Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

  • Ankit Mishra

    1   Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

  • Atul Garg

    2   Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

  • Rungmei Marak

    2   Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

  • Narayan Prasad

    3   Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

  • Praveer Rai

    1   Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

Funding None.
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Graphical Abstract

Abstract

Background

Diarrhea is common in the post-solid organ transplant setting and can be infectious or noninfectious in origin. Among infectious causes of diarrhea norovirus and Clostridioides difficle have been implicated commonly while mycophenolate mofetil is one of the common noninfectious causes. There have been anecdotal reports of sapovirus as cause of chronic diarrhea in post-solid organ transplant recipients.

Methods

We report two such cases with sapovirus-associated chronic diarrhea presenting following renal transplant who were diagnosed on stool multiplex polymerase chain reaction (PCR) testing done at our center.

Results

A 74-year-old lady, post-renal transplant in 2013, presented with chronic diarrhea and weight loss for 9 months and was diagnosed to have sapovirus and norovirus coinfection on stool multiplex PCR testing. She was successfully treated with nitazoxanide and change in immunosuppression to azathioprine. Another 48-year-old lady with renal transplantation in 2014 presented with 6-month chronic diarrhea with acute worsening and acute kidney injury. Her stool multiplex PCR was also positive for sapovirus. She was also successfully managed with fluid repletion, antidiarrheal, nitazoxanide, and change in immunosuppression to enteric-coated mycophenolic acid.

Conclusion

Sapovirus is an emerging cause of post-renal transplant chronic diarrhea. Early recognition is crucial for appropriate management.

Keywords

multiplex PCR - post-transplant diarrhea - sapovirus

Ethical Statement

None.


Authors' Contributions

All authors contributed equally to the article.


Data Availability Statement

There is no data associated with this work.




Publication History

Received: 01 July 2025

Accepted: 16 August 2025

Article published online:
19 November 2025

© 2025. Gastroinstestinal Infection Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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