Infection by Cryptosporidium sp. in immunocompromised haematological patients

Chieffi, Pedro Paulo; Paschoalotti, Maria Aparecida; Vergueiro, Carmen Silvia Vieitas; Chiattone, Carlos S.

doi:10.1590/s0036-46652005000500011

Cited by 7 publications

(5 citation statements)

References 19 publications

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“…Several studies have been conducted on immunosuppressed patients like those with haematological malignancies, PEM, patients receiving immunosuppressive drugs for organ transplants or cancers, patients undergoing dialysis and those having diabetes. These patients have been found to be at significant risk of severe cryptosporidiosis, infection with I. belli, Cyclospora [35][36][37][38][39]. There are reports of three patients with diabetes suffering chronic diarrhea due to cryptosporidiosis [40,41].…”

Section: Discussionmentioning

confidence: 99%

Intestinal Protozoa in Immunosuppression: A Medical Hassle

Ballani¹,

Shujatullah²,

Khan³

2012

J Bacteriol Parasitol

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Introduction: Immunity forms the backbone of our very existence and opportunistic infections have plagued the immunosuppressed since long. A significant morbidity and mortality is attributable to intestinal parasitosis in the immunocompromised population. Objectives:This study aims to study the prevalence of intestinal protozoa in various immunosuppressed groups and to correlate degree of immunosuppression with protozoal infections. Material and Methods:The study was conducted on 400 patients divided into 4 groups: Group I (HIV patients), Group II (patients on chemotherapy/chemotherapy and radiotherapy for various malignancies), and Group III (diabetes patients) and Group IV included children presenting with diarrhea. Group I, II and III included patients with and without gastrointestinal symptoms. Stool samples were investigated microscopically for cysts/trophozoites after concentration with formol-ether method. Iodine wet mount and Modified acid fast staining methods were used. Result:Intestinal protozoa were detected in 40.75% (163/400); more commonly in patients with higher degree of immunosuppression (CD4 count <200/µl in HIV patients: 62.5%, malignancy patients on both chemotherapy and radiotherapy: 71.1%, higher levels of HbA1c >7: 95.3% in diabetics and moderate to severe malnutrition: 61.8%. Most common protozoa associated was Cryptosporidium in 66 patients (40.5%) followed by, Entamoeba histolytica in 48 (29.4%), Giardia lamblia in 35 (21.5%), Isosporabelliin 9 (5.5%), Blastocystis hominis in 4 (2.5%), Cyclospora cayetenensis in 1 (0.61%). Conclusion:High prevalence of intestinal protozoa was seen in all groups of immunosuppressed patients and a significant association seen between degree of immune suppression and protozoal infection. Focus needs to be on routine screening of all immunosuppressed patients and their immune reconstitution.

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Section: Discussionmentioning

confidence: 99%

Intestinal Protozoa in Immunosuppression: A Medical Hassle

Ballani¹,

Shujatullah²,

Khan³

2012

J Bacteriol Parasitol

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“…In this study C. parvum cases occurred exclusively in HIV-positive patients. Other IS groups at significant risk of severe cryptosporidiosis include those diagnosed with non-Hodgkin's lymphoma, leukemia, lymphoproliferative disease, or protein energy malnutrition (51,133,205,215). Patients receiving immunosuppressive drugs for organ transplants or cancers are also at risk of prolonged, potentially life-threatening persistent diarrhea (67,140,238), as are IS patients undergoing hemodialysis (244).…”

Section: Cryptosporidiummentioning

confidence: 99%

Clinical Significance of Enteric Protozoa in the Immunosuppressed Human Population

et al. 2009

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SUMMARY Globally, the number of immunosuppressed people increases each year, with the human immunodeficiency virus (HIV) pandemic continuing to spread unabated in many parts of the world. Immunosuppression may also occur in malnourished persons, patients undergoing chemotherapy for malignancy, and those receiving immunosuppressive therapy. Components of the immune system can be functionally or genetically abnormal as a result of acquired (e.g., caused by HIV infection, lymphoma, or high-dose steroids or other immunosuppressive medications) or congenital illnesses, with more than 120 congenital immunodeficiencies described to date that either affect humoral immunity or compromise T-cell function. All individuals affected by immunosuppression are at risk of infection by opportunistic parasites (such as the microsporidia) as well as those more commonly associated with gastrointestinal disease (such as Giardia). The outcome of infection by enteric protozoan parasites is dependent on absolute CD4+ cell counts, with lower counts being associated with more severe disease, more atypical disease, and a greater risk of disseminated disease. This review summarizes our current state of knowledge on the significance of enteric parasitic protozoa as a cause of disease in immunosuppressed persons and also provides guidance on recent advances in diagnosis and therapy for the control of these important parasites.

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“…Vinte e dois por cento das amostras fecais de crianças iranianas portadoras de leucemia ou linfoma foram positivas para Cryptosporidium, utilizando a pesquisa de coproantígeno pelo ELISA (BERENJI et al, 2007). No Brasil, Chieffi et al (2005) apontaram uma frequência de 10% de criptosporidiose em 60 pacientes com processo linfoproliferativo em São Paulo. No presente estudo, Cryptosporidium sp foi encontrado em duas (2,9%) crianças com câncer (uma com leucemia e outra com tumor sólido no abdômen), dentre as 70 examinadas, utilizando o ZNm e o ELISA.…”

Section: Resultsunclassified

Infecção por Giardia duodenalis e outros enteroparasitos em crianças com câncer e crianças de creche em Salvador, Bahia

Pacheco¹,

Silva²,

Mendes

et al. 2015

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Introdução: Crianças constituem um dos principais grupos de risco de infecções por Giardia duodenalis e outros enteroparasitos. A infecção é geralmente assintomática ou pode evoluir para diarreia aguda ou tornar-se crônica, resultando em perda de peso e retardo no crescimento. Em crianças com tumores malignos, a infecção parasitária pode seguir um curso severo ou mesmo resultar em morte. Objetivo: estabelecer a frequência de G. duodenalis e outros enteroparasitos em fezes de crianças com câncer e de crianças de creche. Metodologia: Amostras fecais foram coletadas de 70 pacientes portadores de câncer e 493 crianças de creche e submetidas às seguintes técnicas de diagnóstico: Baermann-Moraes e cultura de fezes em placa de ágar, flutuação em sulfato de zinco, sedimentação por centrifugação e coloração de Ziehl-Neelsen modificado. Resultados: A frequência de enteroparasitos em crianças com câncer e crianças de creche foi de 47,1% e 35,5%, respectivamente. Os parasitos patogênicos mais prevalentes em crianças com câncer foram Blastocystis hominis (11,4%), seguidos por Giardia duodenalis (8,6%). Nas crianças de creche a Giardia duodenalis foi o parasito patogênico significativamente (p<0,05) mais frequente (27,2%). Conclusão: A elevada ocorrência de enteroparasitos encontrada neste estudo evidencia a necessidade de se realizar o exame parasitológico de fezes regularmente em crianças. Em pacientes pediátricos com câncer, devido à leucopenia causada pelo tratamento quimioterápico, infecções parasitárias concomitantes podem levar a quadros intestinais ou mesmo extraintestinais mais graves, sendo importante o diagnóstico precoce e a intervenção médica.

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Infection by Cryptosporidium sp. in immunocompromised haematological patients

Cited by 7 publications

References 19 publications

Intestinal Protozoa in Immunosuppression: A Medical Hassle

Intestinal Protozoa in Immunosuppression: A Medical Hassle

Clinical Significance of Enteric Protozoa in the Immunosuppressed Human Population

Infecção por Giardia duodenalis e outros enteroparasitos em crianças com câncer e crianças de creche em Salvador, Bahia

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