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PubMed2002

Isosporiasis in children.

The clinical, laboratory and therapeutic data of patients with diarrhea in Human immunodeficiency virus (HIV) antibody positive, immunocompromised and immunocompetent individuals were studied especially to look for prevalence of intestinal coccidiosis. During a study period of one decade, Isospora belli were identified in the stool samples of seven children with diarrhea. Diarrhea persisted for a little longer period in HIV-seropositive children compared to sero-negatives but the clinical picture did not differ significantly in either HIV infected or HIV uninfected individuals.

Child↗
PubMed2002

Tropical malabsorption.

Tropical malabsorption remains an important clinical problem for both the indigenous population of tropical countries and for short-term visitors and longer-term residents from the industrialized world. In young children, persistent diarrhea and malabsorption can result in severe retardation of growth and development. The most common cause is an intestinal infection notably the small intestinal protozoa including Giardia intestinalis, Cryptosporidium parvum, Isospora belli, Cyclospora cayetanensis, and the microsporidia. Tropical sprue still remains an important diagnostic option but is less common than it was 20 to 30 years ago. It is important to attempt to make a specific microbiological diagnosis as this will influence the choice of antibiotic. However, if laboratory facilities are not available, it is possible to offer empirical therapy although this may involve a trial of more than one antibiotic.

Adult↗
PubMed2001

Experimental studies on cyclosporiosis.

Swiss albino mice get Cyclospora infection after orally inoculated with sporulated oocysts. Two weeks post inoculation, most of them passed numerous acid fast immature oocysts in their stools. One week later, light microscopic examination of their intestinal H & E stained sections revealed parasitic stages in a supranuclear location within enterocytes. They were most prominent in the mucosal villi. Lamina propria was expanded by an inflammatory infiltrate. The combined parasitological and histopathological present studies helped in distinguishing Cyclospora which is often confused with Cryptosporidia in stool samples and with Isospora in intestinal sections. Electron microscopy demonstrated both sexual and asexual developmental stages of Cyclospora in ultrathin infected sections. Therefore, Cyclospora species require only a single host to complete its entire life cycle

Animals↗
PubMed2002

[Gastrointestinal manifestations of AIDS in adults in Mali].

Our main objective consists in evaluating the frequency of digestive signs and digestive opportunistic infections in AIDS patients with diarrhea. The prospective study occurred from January 1997 to July 1998 in Bamako hospitals. The patients underwent a clinical examination, blood and stools tests, and sometimes upper digestive endoscopy. Among 434 cases of AIDS, 426 patients (98%) had at least one digestive sign. The main digestive signs were diarrhea (80.1%), abdominal pains (62.2%), vomiting (47.2%) and dysphagea (36.6%). Isospora belli and Cryptosporidium parvum have been pointed up in respectively 9% and 16.3% of examined specimen. Echerichia coli was found in 8.6% of stool cultures and in 2.9% in the case of Salmonella Arizonae. Twenty cases of Kaposi's sarcoma were diagnosed and mycosis was found in 71.9% of patients. In conclusion, digestive change is a constant phenomenon in AIDS patients. Patients survival could be improved by early management, improvement of diagnosis and provisioning of medicines.

AIDS-Related Opportunistic Infections↗
PubMed1996

[Intestinal parasitosis: our series from 1992 to 1995].

From 1992 to 1995 in our Department 2236 researches of intestinal parasites (2194 on stool specimens, 34 on scotch tests, 8 on enterotests) were carried out on 1200 patients (703 HIV-Ab negative and 497 HIV-Ab positive). On the whole 387 samples (17.34%) of 203 subjects (16.92%) were found parasitized; 92 (13.08%) patients of them were HIV-Ab negative and 111 (22.33%) were HIV-Ab positive. We found more frequently Blastocystis hominis and Giardia intestinalis among HIV-Ab negative subjects and Cryptosporidium sp. and Blastocystis hominis among HIV-Ab positive patients. Isospora belli was found exclusively among HIV-Ab positive people, Cryptosporidium sp. in 54 HIV-Ab positive subjects and 3 HIV-Ab negative children. Strongyloides stercoralis was found only in HIV-Ab positive non-European people.

English Abstract↗
PubMedDate not supplied

Cellular immunity and diarrhoeal disease amongst patients infected with the human immunodeficiency viruses 1 and 2 in Zaria, Nigeria.

This study was carried out to determine the aetiological agents associated with diarrhoea in Nigerians infected with the Human Immunodeficiency Viruses, and to correlate the cellular immunity status with the causes of diarrhoea. The mean duration of diarrhoea was 20.7 weeks. Giardia lamblia was the commonest pathogen and was isolated from the stools of 10 patients (25%). Isospora belli was isolated in 3 of the patients (7.5%) but in none of the controls. Other pathogens isolated include salmonella spp. (12.5%), Entamoeba histolytica (7.5%), hookworm (5%), and shigella spp. (5%). No pathogens were identified in seventeen cases (42.5%). No statistically significant difference was established in the stool microbiological findings of the cases and controls. No statistically significant relationship was established between stool microbiological findings and cellular immunity in the patients (ANOVA P > 0.05). It was concluded that the organisms associated with diarrhoea in the HIV-infected patient are similar to those found in HIV-seronegative patients with diarrhoea, and that there is no correlation between the degree of immunodeficiency and the aetiology of diarrhoea.

CD4 Lymphocyte Count↗
PubMed1992

Gastric uptake of gallium-67 in AIDS.

We describe gastric localization of 67Ga in 13 patients with acquired immunodeficiency syndrome (AIDS) among 148 referred primarily to rule out Pneumocystis carinii pneumonia (PCP). Endoscopic biopsies in five of the patients indicated cytomegalovirus (CMV) infection in one, gastritis in two, and normal tissue in two. Other associated, but nongastric, infections in these 13 patients included esophageal candidiasis, PCP, Mycobacterium avium-intracellulare (MAI) complex, coccidioidomycosis, toxoplasmosis and Isospora belli. Only six of the patients exhibited gastric symptoms, and even fewer proved to have gastric pathology. Although gastric 67Ga uptake in a patient with AIDS may not require specific treatment, opportunistic infections as a possible cause of gastritis should be considered.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Protozoan infections and HIV-1 infection: a review.

Reactivation of latent infection is the principal mechanism relating Toxoplasma gondii and Pneumocystis carinii to HIV. Less common is reactivation in Leishmania donovani, Trypanosoma cruzi, and microsporidian infections. An impaired primary immune response occurs in all these infections, and also with Cryptosporidium and Isospora belli. Association of HIV infection with gut parasites including Giardia lamblia and Entamoeba histolytica, and also with Trichomonas vaginalis infection is likely to be related to sexual modes of contact that favour both HIV and the parasite. The severity of malaria is not definitely associated with HIV, but Plasmodium falciparum infection may favour more rapid evolution of the HIV infection. Both malaria and trichomoniasis favour HIV transmission; the former by necessitating blood transfusion, and the latter by enhancing viral transmission during sexual contact.

AIDS-Related Opportunistic Infections↗
PubMed1992

[Fever of unknown origin in a cohort of HIV-positive patients].

The purpose of this study was to determine the prevalence of fever of unknown origin (FUO) in a cohort of HIV positive patients and to describe their evolution and the final diagnosis. The clinical records of 412 patients followed from January 1987 to December 1990 at our HIV outpatient clinic were reviewed: in 151 patients 255 episodes of fever had been observed of which 22 (in 21 patients) met the criteria for FUO. 19 patients (90%) presented with a CDC/WHO stage IV HIV infection and the mean CD4+ lymphocyte count was 0.160 G/l. The etiology was ultimately determined in 13/22 episodes (3 Pneumocystis carinii pneumonia, 3 invasive infections due to atypical mycobacteria, 2 bacterial pneumonia, 1 Cytomegalovirus colitis, 1 Isospora belli enteritis, 1 visceral leishmania, 1 candida septicemia and 1 lymphoma). In 6/22 episodes, the fever subsided after zidovudine was started and was therefore attributed to HIV itself. In 3/22 episodes no etiology was found. In conclusion, this series shows that FUO is usually seen in advanced HIV infection and that it often represents an early sign of opportunistic infection. This observation underlines the importance of follow-up, since it finally served to detect the etiology of FUO in 86% of cases. Trial treatment with zidovudine can be useful where no pathology has been discovered despite 3 weeks' follow-up and appropriate investigations.

AIDS-Related Opportunistic Infections↗
PubMed2003

[Formation and diversity of parasitophorous vacuoles in parasitic protozoa. The Coccidia (Sporozoa, Apicomplexa)].

Data on parasitophorous vacuole (PV) formation in host cells (HC) harbouring different intracellular protozoan parasites have been reviewed and critically analysed, with special reference to the main representatives of the Coccidia. The vacuole membrane (PVM) is the interface between host and parasite, playing a role in nutrient acquisition by the parasite from the HC. The PV phenomenon is regarded as a generalized HC response to the introduction of alien bodies (microorganisms), which eventually reflects the evolutionary established host-parasite relationships at cellular, subcellular and molecular levels. Special attention has been paid to the existing morpho-functional diversity of the PVs within the same genera and species of parasites, and even at different stages of the parasite life cycle. The PVM is generally considered to derive from the HC plasmalemma, whose biochemical composition undergoes significant changes as the intravacuolar parasite grows. The original HC proteins are selectively excluded from the PVM, while those of the parasite are incorporated. As the result, the changed PVM becomes not fusigenic for HC lysosomes. For Toxoplasma gondii and other cyst-forming coccidia (Isospora, Sarcocystis), a definite correlation has been noticed between the extent of rhoptry and dense granule secrets released by a zoite during HC internalization, on the one hand, and the pattern of the PV that forms, on the other one. In T. gondii, tachyzoites, known to discharge abundant secrets, commonly force the development of PVs limited with a single unit membrane and equipped with a tubulovesicular network in the lumen. Unlike, bradyzoites known to be deficient in secretory materials trigger the formation of PVs with a three-membrane lining composed of the changed invaginated plasmalemma in addition to two membranes of endoplasmic reticulum. The two different types of PV harbour, respectively, exoenteric and enteric stages of T. gondii, the latter being confined to the cat intestine only. Unlike, all endogenous stages of the classic intestinal coccidia (Eimeria spp.) develop within PVs limited with a single membrane, with some invaginations extending into the PV lumen. Unusual PV patterns are characteristic of the extracytoplasmic eimerian coccidia (Cryptosporidium, Epieimeria) and adeleid haemogreagarines (Karyolysus). In cyst-forming coccidia, the PVM is actively involved in tissue cyst wall formation, thus protecting the encysted parasites from recognition by the host immune system. All this strongly suggests that the PV is far from being an indifferent membraneous vesicle containing a parasite, but represents a metabolically active compartment in infected cells. Since all the coccidia are obligate intracellular parasites, the mode of their intimate interaction with the HC, largely accomplished via the PV and its membrane, is vital for their survival as biological species.

Animals↗
PubMed2000

[Parasitoses and immunodepression].

The immunodepression, related or not to AIDS, induces the emergence of opportunistic parasitosis and mycosis. Our objective is to analyze these pathogenic agents, their clinical expression and gravity in immunocompromised individuals. Our retrospective 9 years study reported parasitic and fungic infections complicating immunodepression. Among 31 HIV infected patients, we diagnosed the following parasitosis: Cryptosporidium (7 cases), Isospora belli (2 cases) and Enterocytozoon bieneusi (1 case). Pulmonary pneumocystosis was diagnosed in 6 cases, cerebral toxoplasmosis in 6 cases and meningo-cerebral cryptococcosis in 1 case. The systemic candidasis was diagnosed in 13 leukaemic patients. The intestinal anguilluliasis was found in 5 patients treated with corticoïds for long periods. A case of Kala azar was observed in a 83 years man treated with corticoïds. A disseminated aspergillosis occurred in a child with a Chediack Higashi syndrome. A gingivo-labial fusariosis was diagnosed in a leukaemic patient. This emergency of the new parasitic and fungal agents requires a better understanding of these affections in order to improve their early diagnosis and treatments.

AIDS-Related Opportunistic Infections↗
PubMed2003

Needle necropsy in AIDS.

The value of autopsy in understanding the natural course of any disease is beyond any argument. The reluctance of pathologists to perform autopsy in HIV infected cadavers is justified due to the risks involved to the prosector and the morgue attendants. A relative low risk needle necropsy protocol is proposed using fine needle aspiration cytology, tru-cut biopsies and microbiological examination. Diagnosis could be offered in all the forty-four needle necropsies performed. Disseminated tuberculosis in 18/44 (40.9%) cases, disseminated cryptococcosis in 12/44 (27.2%) cases, poly-microbial infections in 27.2% cases and non-Hodgkin's lymphoma in 9% cases were detected in the study. Infectious agents like Histoplasma capsulatum, Isospora belli, tachyzoites of Toxoplasma gondii, Candida sp and Cryptococcus sp could be demonstrated in the samples obtained in the study. Lack of material for study of gross pathology, inaccessibility of deep-seated lesions and risk of needle stick injury to the prosector though low are the limitations of this procedure.

AIDS-Related Opportunistic Infections↗
PubMed2003

Foodborne and waterborne parasites.

More than 72 species of protozoan and helminth parasites can reach humans by food and water, and most of these infections are zoonoses. Some parasites show a cosmopolitan distribution, others a more restricted distribution due to their complex life cycles, which need the presence of one or more intermediate hosts. Of this large number of pathogens, only Toxoplasma gondii can be transmitted to humans by two different ways, i.e., by cysts present in infected meat and by oocysts contaminating food and water. Eleven helminthic species (Taenia saginata, Taenia solium, Taenia asiatica, Trichinella spiralis, Tr. nativa, Tr. britovi, Tr. pseudospiralis, Tr. murrelli, Tr nelsoni, Tr. papuae and Tr. zimbabwensis) can grow in meat of different animal species and can be transmitted to humans by the consumption of raw meat or meat products. Twenty trematode species, four cestode species and seven nematode species can infect humans through the consumption of raw sea- and/or fresh-water food (fishes, molluscs, frogs, tadpoles, camarons, crayfishes). Six species of Cryptosporidium, Isospora belli, Cyclospora cayetanensis, Giardia duodenalis and Entamoeba histolytica/E. dispar can contaminate food and water. Among the helminths, seven trematode species, seven cestode species and five species of nematodes can reach humans by contaminated food and water. Diagnostic and detection methods that can be carried out routinely on food and water samples are available only for few parasites (Cryptosporidium sp., Giardia sp., Anisakidae, Trichinella sp., Taenia sp.), i.e., for parasites which represent a risk to human populations living in industrialised countries. The majority of food and waterborne infections of parasitic origin are related to poverty, low sanitation, and old food habits.

Animals↗
PubMedDate not supplied

[Investigation of intestinal parasites in AIDS patients].

In this study, enteric parasites were investigated in the stool samples of 38 AIDS patients (23 with chronic diarrhea and 15 without diarrhea) prospectively. At least three stool samples from each patient were investigated microscopically for ova or trophozoites. The samples were concentrated with formol-ether method and wet preparations stained with lugol were examined. In addition, the concentrated samples were stained with modified asid-fast (Kinyoun's), rhodamine-auramine, modified trichrom and calcoflor methods. Enteric parasites were detected in 18 (47%) of the 38 patients, 16 patients harbored a single parasite, and 2 patients were found to be infected with more than one parasite. Only one (7%) of 15 AIDS patients without diarrhea, were found to be infected with Giardia lamblia. On the other hand, 17 (74%) of 23 AIDS patients with chronic diarrhea were found to be infected with various enteric parasites. Cryptosporidium spp. was detected in 9 (39%) of these 23 patients, and in 2 of them Microsporidium spp. accompanied Cryptosporidium. In 2 (9%) of these 23 patients G. lamblia were detected, while Isospora belli, Blastocystis hominis, Entamoeba histolytica, Strongyloides stercoralis and Trichuris trichiura were detected in one patient each. As a result, the detection rate of emerging parasites, including Cryptosporidium spp, Microsporidium spp, I. belli, B. hominis, and S. stercoralis was significantly higher than conventional parasites (39% versus 13%; z=2.34, p=0.01), and CD4 T cell counts were found to be significantly lower among AIDS patients with chronic diarrhea than those without diarrhea (x2=34.33, p<0.001).

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Intestinal parasites, including Cryptosporidium species, in Iraqi patients with sickle-cell anaemia.

Stool samples were obtained from individuals admitted to three hospitals in Basra during November 1997-May 1998. Of 40 patients with sickle-cell anaemia, 25 (62.5%) had parasitic infections. In the apparently healthy comparison group, 26 of 175 individuals (14.8%) had intestinal parasitic infections, a statistically significant difference. The most common intestinal parasites isolated in the sickle-cell patients were Blastocystis hominis (36%) and Giardia lamblia (28%). The isolation rate of Cryptosporidium species in sickle-cell patients (5%) was not significantly different from that in apparently healthy individuals (1.14%). We report for the first time the isolation of Isospora belli from a sickle-cell patient in Iraq and the Mediterranean region.

Adolescent↗
PubMedDate not supplied

Comparison of conventional coproscopical methods and commercial coproantigen ELISA kits for the detection of Giardia and Cryptosporidium infections in dogs and cats.

Faecal samples of 270 dogs and 100 cats from 3 animal shelters in Germany were comparatively examined using conventional coproscopical methods and commercial coproantigen ELISA kits for the detection of Giardia and Cryptosporidium infections. Giardia cysts were found in 9.5% and 0% of the faecal samples in dogs and cats, respectively, examined once using the ZnCl2-NaCl flotation. However, the Giardia coproantigen ELISA (ProSpecT Giardia Microplate Assay) was positive in 29.5% and 22.4% of the samples from dogs and cats, respectively. Direct faecal smears stained with carbol fuchsin showed Cryptosporidium oocysts in one dog (0.4%) and one cat (1%). In contrast, the Cryptosporidium coproantigen ELISA (ProSpecT Cryptosporidium Microplate Assay) reacted positively in 23% of the samples from dogs and 30% of the samples from cats. Both coproantigen ELISAs were more often positive in coproscopically Giardia-negative canine faecal samples that contained Isospora burrowsi/ohioensis oocysts than in faecal samples without any parasite stage. Possible reasons for these observations are discussed.

Animals↗
PubMed2004

Survey for intestinal parasites in Belize, Central America.

A stool survey was carried out in 5 villages in the Toledo district of the Central American country of Belize. Eighty-two percent of a total population of 672 participated. The stools were examined by the formalin-ethyl-acetate concentration technique. Sixty-six percent of the population was found to have one or more intestinal parasites. The most common infection was hookworm (55%) followed by Ascaris lumbricoides (30%), Entamoeba coli (21%), Trichuris trichiura (19%), Giardia lamblia (12%), Iodamoeba beutschlii (9%), and Entamoeba histolytica/dispar (6%). Other parasites found were Entamoeba hartmani, Strongyloides stercoralis, Endolimax nana, Isospora belli, and Chilomastix mesnili. Children were more often infected than adults and more females had hookworm infections. Sixty percent of 111 households surveyed had dirt floors, 43% were without toilets, 35% of the houses were overcrowded, and 10% obtained drinking water from streams. Cross-tabulation and logistic regression analyses were used to identify risk and protective factors associated with parasitoses. The risk factors were: being in the Mayan Ketchi population group, and abtaining housework and drinking water from streams. Protective factors were: drinking treated water and the wearing of shoes.

Adolescent↗
PubMed1992

Coccidial infection in German shepherd dog pups in a breeding unit.

A commercial dog breeding unit experienced problems with acute diarrhoea, often haemorrhagic, in young German Shepherd Dog litters. No aetiologic diagnosis had been made. In order to determine whether coccidial infections were implicated, a survey was conducted to ascertain shedding of oocysts by dams, acquisition of coccidial infection by neonatal pups and to determine whether bouts of diarrhoea were associated with peak oocyst production. Oocysts of Isospora canis and I. burrowsi/I. ohioenis were recovered from 26.0% of faecal specimens from bitches and from 51.7% of similar specimens from litters. No association between shedding of oocysts by bitches and their litters could be demonstrated, nor was there consistent association between bouts of diarrhoea and peaks of oocyst shedding.

Animals↗