Diarrhea Workup and Management Algorithm in Transplant Patients

First Tier Microbiologic-Testing:

1. C. difficile PCR (Stool)

2. CMV qPCR (Serum/Blood)

3. Norovirus PCR (Stool)

4. Bacterial culture (Stool)

  * If available consider multiplex PCR for Broad range of enteric pathogens

First Tier Microbiologic-Testing:

1. Ova and Parasite evaluation (stool)

2. Giardia and Cryptosporidium EIA (Stool)

3. Breath test for bacterial overgrowth

If above testing negative and diarrhea persists:

1. Adjust IS medications *Reduce dose of change to different agent

2. Colonoscopy +/- EGD *Especially if concern for PTLD, GVHD or IBD

3. Empiric therapy with probiotic or anti-motility agents

4. Evaluate for malabsorption



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