Supplementary Material for: Infection of Enterocytozoon bieneusi in a patient with long-term immunosuppression after liver transplantation: a case report and literature review

Enterocytozoon bieneusi (E.b) can cause opportunistic infections in immunocompromised patients especially HIV/AIDS recipients, but currently there are still few case reports of E.b infections in solid organ transplant recipients. As E.b cannot be diagnosed by routine examination and culture, it is often overlooked as a possible cause of chronic diarrhea in transplant recipients. With no known established guidelines for E.b, the effective and available treatment options are limited. In this article, we reported a case of persistent chronic diarrhea and renal failure due to E.b infection after liver transplantation, which was definitively diagnosed using metagenomic Next Generation Sequencing (mNGS). Short course of Albendazole was applied to the patient, resulting in rapid resolution of clinical symptoms and recovery of renal function. The case demonstrates the advantages of mNGS for the diagnosis of rare pathogenic bacterial infections, and together with the previous case reports further suggests Albendazole may serve as a effective therapy for the treatment of E.b for some patient.This article reviews relevant literature and provides an updated and more comprehensive reference for the selection of E.b treatment drugs. To be note, the overview showed there may be individualized differences in the efficacy of Albendazole, which needs more study.