Immunosuppressed patients and sushi?

[Sparda29]

One of my patients asked if they could still eat sushi and sashimi now that they are on immunosuppressants for a heart transplant. I was actually stumped by this, never heard of anyone getting an infection off of sushi? 😕

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[eagles22]

My friend's mother had a kidney transplant and is on several immunosupressants. She eats sushi and is fine. n=1.

 

[notamember82]

Concern is for V. Vulnificus.

 

[confettiflyer]

Properly stored and prepared it should be fine, similar to the myth that pregnant people shouldn't eat nigiri/sashimi.

 

[notamember82]

Actually it depends on the txp.

 

[Rx MPLS]

I would avoid it. Worms and bacteria exist even in clean, fresh fish. Why take the risk if you don't have an immune system to back you up?

A quick example of an article talking about tapeworm associated with fish consumption (see page 2 for a disturbing 150 year old drawing of tapeworm infection!): http://wwwnc.cdc.gov/eid/article/15/6/pdfs/09-0132.pdf

 

[npage148]

I may be wrong but all sushi in the us is frozen to kill parasites. It's like law or something

 

[confettiflyer]

I may be wrong but all sushi in the us is frozen to kill parasites. It's like law or something

I believe so, I read the law a while ago, but I can't find it. It's like X degrees for X # of days, but variances apply. I've been to places that will filet a fish that was just alive when I walked in, so it probably didn't apply there.

 

[rxlea]

All I'm gonna say is that I've seen a patient that was immunocompromised get a severe infection from eating something they probably weren't supposed to shortly after a surgery. That patient almost died. It was one of the weirdest things I've ever seen in my life....

 

[Praziquantel86]

Vibrio parahaemolyticus is the leading cause of bacterial gastroenteritis in Japan...I think they eat a lot of sushi over there, but might be mistaken. It's pretty much universal on shellfish.

Most transplant centers recommend avoiding raw meats/fish after transplant (forever), as do the KDOQI guidelines. Not aware of any literature to support this, but given the risk/benefit ratio, it would seem to be prudent.

 

[pharmasaur]

All I'm gonna say is that I've seen a patient that was immunocompromised get a severe infection from eating something they probably weren't supposed to shortly after a surgery. That patient almost died. It was one of the weirdest things I've ever seen in my life....

what did they eat?

 

[rxlea]

what did they eat?

bread😱

 

[Sparda29]

bread😱

What what the surgery for?

 

[rxlea]

What what the surgery for?

Lets just say that I doubt I'll ever see mold growing out of someone's abdomen like that ever again. Rhizopus Stolonifer. And I mean, it was every where. 😱