Sapovirus-Associated Severe, Prolonged Diarrhoea in an Autologous Stem-Cell Transplant Patient: Case Report and Literature Review

This immunocompromised patient suffering from severe sapovirus colitis and enteritis became dehydrated and losing weight. He was admitted to our intensive care unit but relapsed after two months of follow-up while on intravenous immunoglobulin maintenance. Sapovirus is becoming an increasingly important pathogen responsible for sporadic and epidemic acute gastroenteritis worldwide, especially in young children. It is usually diagnosed by multiplex RT-PCR analysis of feces, which can differentiate it from other causes of infectious diarrhoea. Sapovirus does not seem to cause more severe infections in immunocompromised patients or to lead to chronic infections due to the emergence of recombinant strains, unlike norovirus, a Calicivirus with several similar features. Its potential for nosocomial epidemics is also still unclear. Most treatment of sapovirus infections focus on the symptoms as the disease is often benign. No specific antiviral treatment is presently licensed. Perhaps the proposed use of immunoglobulins or nitazoxanide to treat norovirus in immunocompromised patients could be extended to sapovirus, but these procedures remain experimental. We suggest that this increasingly important enteric pathogen that can cause severe, prolonged diarrhoea in immunocompromised patients should be closely monitored.