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Profound diarrhoea and weight loss in an immunocompromised patient
  1. George Ashton,
  2. Alan Shand,
  3. Ian Arnott and
  4. Shahida Din
  1. Gastroenterology Unit, NHS Lothian, Edinburgh, UK
  1. Correspondence to Dr George Ashton; george.ashton{at}


A 75-year-old man was admitted with a 3-month history of worsening diarrhoea and weight loss. He was on long-term immunosuppression following cardiac transplantation. Investigations revealed herpes simplex oesophagitis and stool samples were positive for norovirus. Treatment with acyclovir and nitazoxanide resulted in a complete resolution of symptoms. Norovirus is a common cause of infectious gastroenteritis, but immunosuppressed patients may present with chronic diarrhoea rather than an acute illness. This case highlights the importance of a low clinical threshold for testing for norovirus infection in immunocompromised patients.

  • gastroenterology
  • infection (gastroenterology)
  • infectious diseases

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  • Contributors GA created the first draft of the case report. AS, IA and SD reviewed and contributed to subsequent drafts and the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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