table 1. Patient Demographics and Gastrointestinal Pathogen Confirmatory Testing Age/
Underlying Disease
Case Gender (+ t-HSCT) Signs/ Symptoms Chemotherapy Treatment
Entamoeba histolytica 1 42/M AML (Y) Diarrhea
2 66/M AML (Y) Diarrhea, colitis on imaging
3 65/M DLBCL (Y) Diarrhea 4 8/M ALL (N) Diarrhea,
abdominal pain, fever
5 5/F ALL (Y) Diarrhea,
abdominal pain
Salmonella 1 25/M GCT (Y) Diarrhea,
abdominal pain, fever
2 3
68/F Lung (N) Diarrhea 41/F ATLL (Y) No symptoms Y N
β-lactam β-lactam
+ −− No growth −
+
City and New York State departments of health; ND, not done. aAll Luminex median fluorescence intensity results exceeded the manufacturer’s thresholds for a positive result. bOverall Salmonellae recovery in culture from January 2016 to December 2017 was 27% (10 of 37 isolates).
+ No growth
No growth ND
NOTE. HSCT, hematopeotic stem cell transplant; GPP, gastrointestinal pathogen panel; FA, fluorescent antibody; PCR, polymerase chain reaction; EH, Entamoeba histolytica; AML, acute myeloid leukemia; DLBCL, diffuse large B-cell lymphoma; GCT, germ cell tumor; ATLL, adult T-cell leukemia/lymphoma; MSK, Memorial Sloan Kettering; NYC&NYS DOH, New York
Y β-lactam + −− No growth No growth Cluster 2 Y
Y Y Y Y
Metronidazole, parmomycin
Metronidazole, parmomycin
Metronidazole, parmomycin
Metronidazole, parmomycin
Metronidazole, parmomycin
Luminex Resulta
BioFire GPP Result
Acid Fast Stain
E.
Giardia FA
+ −− − + −− − + −− − −
+ + Initial
Luminex GPPa
−
Luminex GPP
(repeat)a
Cryptosporidium FA
− − −
ND ND ND ND
BioFire GPP
ND ND MSK cultureb
Trichorme Stain
− − −
dispar PCR
− − −
EH PCR
− Cluster 1 − −
ND ND ND ND ND ND
NYC & NYS DOH culture
multiplex gi panels in immunocompromised host 869
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