Intestinal protozoan infections in the immunocompromised host

Marcos, Luis A.; Gotuzzo, Eduardo

doi:10.1097/qco.0b013e3283630be3

Cited by 75 publications

(58 citation statements)

References 47 publications

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“…Cancer patients run a great risk of developing enteroparasitic infections, as they are more susceptible to opportunistic agents due to anticancer treatment and are already immunocompromised because of the disease itself (Vento and Cainelli, 2003). These opportunistic infections are usually more severe in this group of individuals, and may even lead to fatal complications (Marcos and Gotuzzo, 2013). Of the 73 participants in the study, 45 (61.6%) were positive for one or more parasitic species, a similar index to that found in other studies, such as a 66.7% figure found in cancer patients in Brazil (Silva et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

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Intestinal parasites in cancer patients in the South of Brazil

et al. 2017

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Intestinal parasitic infections in immunocompromised patients can lead to serious complications when not diagnosed and treated early. This study aimed to investigate the frequency of intestinal parasites in cancer patients undergoing chemotherapy in the South of Brazil. Three fecal samples collected from each patient (73 individuals) were processed by Ritchie and Faust techniques and submitted to specific staining methods for intestinal protozoa. A 61.6% parasite and/or commensal positivity was found. Helminths identified were Ascaris lumbricoides (33.3%), Taenia spp. (6.6%), Strongyloides stercoralis (4.4%) and Trichuris trichiura (2.2%). Among protozoans, Giardia lamblia (26.6%), Cryptosporidium spp. (13.3%) and Cystoisospora belli (4.4%) were identified. The presence of Entamoeba coli, Endolimax nana and Entamoeba hartmanni was also recorded. The results obtained warn of the importance of fecal parasitological diagnosis and the use of specific staining methods for the detection of intestinal parasites in cancer patients. These exams should be regularly requested at the patient's first clinic visit, given the high prevalence found in this study and the possible severity of such conditions for these individuals.Keywords: intestinal parasites, immunocompromised patients, cancer. Parasitos intestinais em pacientes com câncer do Sul do Brasil ResumoAs parasitoses intestinais em pacientes imunocomprometidos podem levar a graves complicações se não diagnosticadas e tratadas precocemente. Este estudo teve como objetivo investigar a frequência de parasitos intestinais em pacientes oncológicos submetidos ao tratamento quimioterápico. Foram coletadas três amostras de fezes de cada paciente, sendo processadas pelas técnicas de Ritchie e Faust e submetidas à métodos de coloração específicos para protozoários intestinais. Foi encontrada positividade de 61,6% para parasitos e/ou comensais. Os helmintos identificados foram Ascaris lumbricoides (33,3%), Taenia spp. (6,6%), Strongyloides stercoralis (4,4%) e Trichuris trichiura (2,2%). Dentre os protozoários, foram identificados Giardia lamblia (26,6%), Cryptosporidium spp. (13,3%) e Cystoisospora belli (4,4%). Também foi registrada presença de Entamoeba coli, Endolimax nana e Entamoeba hartmanni. Os resultados encontrados alertam para a importância do diagnóstico parasitológico de fezes junto à utilização de colorações específicas para parasitos intestinais em pacientes oncológicos, sendo que os mesmos deveriam ser requeridos como conduta já na primeira consulta clínica destes pacientes, dada à elevada prevalência aqui constatada e a possível severidade que tais moléstias podem acarretar nestes indivíduos.Palavras-chave: parasitos intestinais, pacientes imunocomprometidos, câncer.

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Section: Discussionmentioning

confidence: 99%

“…Despite sanitation improvement and hygiene education in recent decades, these infections continue to be characterized as a major cause of morbidity worldwide (Lustigman et al, 2012). In immunocompromised individuals, such agents are recognized as important enteric pathogens, and may lead to fatal complications (Marcos and Gotuzzo, 2013).…”

Section: Introductionmentioning

confidence: 99%

Intestinal parasites in cancer patients in the South of Brazil

et al. 2017

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“…Recurrences are common, and the chronic nature of the illness contributes to morbidity and mortality among these patients (204)(205)(206). Sulfamethoxazole-trimethoprim treatment provides a good clinical response and is the drug of choice (207).…”

Section: Cystoisosporamentioning

confidence: 99%

Molecular Testing for Clinical Diagnosis and Epidemiological Investigations of Intestinal Parasitic Infections

2014

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SUMMARY Over the past few decades, nucleic acid-based methods have been developed for the diagnosis of intestinal parasitic infections. Advantages of nucleic acid-based methods are numerous; typically, these include increased sensitivity and specificity and simpler standardization of diagnostic procedures. DNA samples can also be stored and used for genetic characterization and molecular typing, providing a valuable tool for surveys and surveillance studies. A variety of technologies have been applied, and some specific and general pitfalls and limitations have been identified. This review provides an overview of the multitude of methods that have been reported for the detection of intestinal parasites and offers some guidance in applying these methods in the clinical laboratory and in epidemiological studies.

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“…Evidence has emerged showing that the infection could contribute to development of different forms of dysregulations within the intestinal tract including disseminated infection, especially in patients suffering from AIDS (Harp 2003). These GI protozoa are progressively becoming recognized as important pathogens in patients that are immunocompromised (Marcos and Gotuzzo 2013). This is especially important as the number of people who are immunocompromised increases as the human immunodeficiency virus (HIV) continues to spread in many parts of the world (Stark et al 2009).…”

Section: Introductionmentioning

confidence: 97%

“…Recently, it has been found that an impaired host T cell immune response may facilitate an invasion by intestinal protozoa, however the exact pathogenesis at a cellular level remains unclear (Marcos and Gotuzzo 2013). Transplant patients along with patients infected with HIV have been reported to be at a higher risk of developing severe disease (Kristensen et al 2016).…”

Section: Introductionmentioning

confidence: 99%

An overview of parasitic infections of the gastro-intestinal tract in developed countries affecting immunocompromised individuals

Siddiqui

2017

J Parasit Dis

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In both developed and developing countries, parasitic infections continue to be a frequent cause of mortality and morbidity. Due to the globalization of the world, doctors must be fully prepared to deal with a plethora of parasitic infections. More commonly the gastrointestinal (GI) tract is infected and in developed countries protozoans are more likely to be the cause of infection compared to helminths. These GI protozoa are progressively becoming recognized as important pathogens in patients that are immunocompromised. The number of immunocompromised patients is increasing and therefore the likelihood of similar infections will also increase. This paper aims to highlight the key GI parasites affecting immunocompromised individuals in developed countries, discussing diagnosis, treatment options and also prevention. may be the most common GI parasite found in the immunocompromised host closely followed by Cyclospora, however, is the most common GI parasite found in developed countries. The pathogenesis of parasitic infection is not clear, poorly understood and diagnostic testing remains difficult with management continuing to be a challenge.

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Intestinal protozoan infections in the immunocompromised host

Cited by 75 publications

References 47 publications

Intestinal parasites in cancer patients in the South of Brazil

Intestinal parasites in cancer patients in the South of Brazil

Molecular Testing for Clinical Diagnosis and Epidemiological Investigations of Intestinal Parasitic Infections

An overview of parasitic infections of the gastro-intestinal tract in developed countries affecting immunocompromised individuals

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