Recurrent Isosporiasis Over a Decade in an Immunocompetent Host Successfully Treated with Pyrimethamine

Jongwutiwes, Somchai; Sampatanukul, Pichet; Putaporntip, Chaturong

doi:10.1080/0036554021000026947

Cited by 18 publications

(20 citation statements)

References 4 publications

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“…In immunocompetent individuals, infection with Isospora typically leads to a moderate to severe illness characterized by fever, vomiting, diarrhea, abdominal pain, and malaise. Without treatment, most infections resolve in about 2 weeks, but some persist for many months or even years [3,4]. Isosporiasis is most prevalent among the immunosuppressed and is a relatively uncommon but wellknown opportunistic pathogen in AIDS patients [5].…”

Section: Discussionmentioning

confidence: 99%

Isospora cholangiopathy: case study with histologic characterization and molecular confirmation

Walther

Topazian

2009

Human Pathology

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Section: Discussionmentioning

confidence: 99%

Isospora cholangiopathy: case study with histologic characterization and molecular confirmation

Walther

Topazian

2009

Human Pathology

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“…As with other opportunistic protozoal pathogens, clinical manifestations are dependent on the balance between the immune system and the virulence of the organism, with chronic carriage states ("latency") and clinically symptomatic reactivation during periods of severe immunodeficiency (152), as reported for a recent case of reactivation 8 years following acquisition (234).…”

Section: Isospora Bellimentioning

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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“…[3][4][5][6]9 Clinical manifestations are dependent on the balance between the immune system and the virulence of the organism, with latency and clinically symptomatic reactivation during period of severe immunodeficiency. 10 Although the reactivation has been reported with other parasitic infections, we did not see any evidence of infection on previous small bowel biopsies. 11 We believe that this was a de novo infection in the setting of immunosuppression.…”

Section: Discussionmentioning

confidence: 71%

Isospora belli superinfection in a patient with eosinophilic gastroenteritis—A diagnostic challenge

Navaneethan

Venkatesh

Downs‐Kelly

et al. 2012

Journal of Crohn's and Colitis

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Isospora belli infection, characterized by peripheral blood eosinophilia, is often seen as an opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS). It is also reported in patients with underlying lymphoproliferative disorders including lymphoma and leukemia. Eosinophil-associated gastrointestinal disorders (EGID), including eosinophilic gastroenteritis (EGE), is characterized by eosinophilic infiltration of the gastrointestinal (GI) tract with various GI symptoms. We report a case of a 50-year-old male who developed Isospora superinfection of the small bowel while receiving systemic corticosteroids for EGE. He presented with worsening diarrhea, abdominal pain, nausea and vomiting with worsening peripheral eosinophilia. I. belli infection was diagnosed by the detection of oocysts in stool samples and by the presence of the parasite on duodenal biopsy in the background of tissue eosinophilia. I. belli can cause severe chronic diarrhea in immunocompromised patients on corticosteroids. Trimethoprim-sulfamethoxazole often provided rapid cure. Even though peripheral blood eosinophilia was seen in both EGE and Isospora infection, the identification of subnuclear protozoal inclusions as a new histologic finding, as well as the absence of this finding in previous duodenal biopsies coupled with the continued presence of tissue eosinophilia, favored a parasitic superinfection in the setting of underlying EGE.

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Recurrent Isosporiasis Over a Decade in an Immunocompetent Host Successfully Treated with Pyrimethamine

Cited by 18 publications

References 4 publications

Isospora cholangiopathy: case study with histologic characterization and molecular confirmation

Isospora cholangiopathy: case study with histologic characterization and molecular confirmation

Clinical Significance of Enteric Protozoa in the Immunosuppressed Human Population

Isospora belli superinfection in a patient with eosinophilic gastroenteritis—A diagnostic challenge

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