Cryptosporidiosis of the biliary tract mimicking pancreatic cancer in an AIDS patient

Souza, Lenice do Rosário de; Rodrigues, Maria Aparecida Marchesan; Morceli, José; Kemp, Raphael; Mendes, Rinaldo Pôncio

doi:10.1590/s0037-86822004000200015

Cited by 14 publications

(7 citation statements)

References 16 publications

(7 reference statements)

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“…Several studies have documented a decline in the prevalence of cryptosporidiosis after the introduction of ART since this therapy suppresses the replication of HIV, leading to an increase in circulating CD4 + T lymphocytes and intestinal repopulation, and subsequently the restoration of mucosal immunity 17,26,28 .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and genetic characterization of Cryptosporidium spp. and Cystoisospora belli in HIV-infected patients

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Cabrine-Santos

et al. 2013

Rev. Inst. Med. trop. S. Paulo

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SUMMARYCryptosporidium spp. and Cystoisospora belli are monoxenic protozoa that have been recognized as the causative agents of chronic diarrhea in immunocompromised individuals, especially HIV-infected subjects. The objective of this study was to evaluate the frequency of these intestinal protozoa in HIV-positive patients in the Triângulo Mineiro region of Brazil and to correlate the presence of these infections with clinical, epidemiological and laboratory data of the patients. Oocysts were detected in stool samples of 10 (16.9%) of the 59 patients studied, while Cryptosporidium spp. were present in 10.1% (6/59) and C. belli in 6.7% (4/59). The frequency of these parasites was higher among patients with diarrheic syndrome and CD4 + T lymphocyte counts < 200 cells/ mm 3 , demonstrating the opportunistic characteristic of these infections. A significant association was observed between the lack of adherence to antiretroviral therapy and the presence of Cryptosporidium spp. and/or C. belli. Parasitism with Cryptosporidium spp. was more frequent in February and April, the months following the period of high rainfall. The same was not observed for C. belli. Genetic characterization of two isolates led to the identification of Cryptosporidium parvum, one of the main species associated with the zoonotic transmission of cryptosporidiosis.

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Section: Discussionmentioning

confidence: 99%

Prevalence and genetic characterization of Cryptosporidium spp. and Cystoisospora belli in HIV-infected patients

Assis

Resende

Cabrine-Santos

et al. 2013

Rev. Inst. Med. trop. S. Paulo

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“…This may be difficult to diagnose, and a recent Brazilian patient presented with symptoms mimicking carcinoma of the head of the pancreas [26]. A case report from New Zealand suggests a link between infection and reactive arthritis, something that had only previously been seen in children or in HIVpositive adults [27].…”

Section: Cryptosporidiosismentioning

confidence: 99%

Gastrointestinal parasites in the immunocompromised

Lewthwaite

Gill

Beeching

2005

Current Opinion in Infectious Diseases

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Parasitic infections remain a significant problem for immunocompromised individuals in resource-poor settings, and further work is needed to develop accessible diagnostic tests and to improve our understanding and management of their pathogenic effects. New concepts about the interactions of helminths with host immunity suggest the need for collection of further epidemiological and clinical data to unravel the complexities of such immunological interactions.

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“…Fever was present in approximately one-third of patients and malabsorption was common. The epithelium of the biliary tract and the pancreatic duct could be infected with Cryptosporidium, leading to sclerosing cholangitis and to pancreatitis secondary to papillary stenosis, particularly among patients with prolonged disease and low CD4 cell counts (De Souza et al, 2004). Pulmonary infections also have been reported may be under-recognized (Mercado et al, 2007).…”

Section: Introductionmentioning

confidence: 99%