Cystoisospora belli infections in humans: the past 100 years.

Cystoisospora belli is a coccidian parasite of humans, with a direct fecal-oral transmission cycle. It is globally distributed, but mainly found in tropical and subtropical areas. Many cases of C. belli infections have been reported in patients with HIV, and in patients undergoing immunosuppressive therapy for organ transplants or those treated for tumours worldwide. Unsporulated or partially sporulated oocysts of C. belli are excreted in feces. When sporulated oocysts in contaminated water or food are ingested, asexual and sexual stages of C. belli are confined to the epithelium of intestines, bile ducts and gallbladder. Monozoic tissue cysts are present in extra-intestinal organs (lamina propria of the small and large intestine, lymph nodes, spleen, and liver) of immunosuppressed humans. However, a paratenic host has not been demonstrated. Cystoisospora belli infections can be persistent, lasting for months, and relapses are common; the mechanism of relapse is unknown. Recently, the endogenous stages of C. belli were re-examined and attention was drawn to cases of misidentification of non-protozoal structures in the gallbladder of patients as C. belli. Here, we review all aspects of the biology of C. belli, including morphology, endogenous stages, prevalence, epidemiology, symptoms, diagnosis and control.

Re-evaluation of merogony of a Cystoisospora ohioensis-like coccidian and its distinction from gametogony in the intestine of a naturally infected dog.

Four species of Cystoisospora, C. canis, C. ohioensis, C. neorivolta and C. burrowsi are described from feces of dogs. Of these, the oocysts of C. canis are the largest and easily distinguished from the remaining three species. Oocysts of C. ohioensis, C. neorivolta and C. burrowsi are difficult to distinguish because of overlap in their sizes. However, based on endogenous developmental stages, C. ohioensis is distinct from C. neorivolta and C. burrowsi because its endogenous stages are confined to surface epithelium of intestine whereas endogenous stages of C. neorivolta and C. burrowsi are predominantly in the lamina propria. There are uncertainties regarding the endogenous stages of C. neorivolta and C. burrowsi and there is no way now to determine whether C. burrowsi and C. neorivolta are different parasites; therefore, these are referred as C. ohioensis-like organisms. Additionally, mode of division of asexual stages of coccidia of dogs is largely unknown and ultrastructural studies are lacking. In the present study, development of asexual and sexual stages of a C. ohioensis-like organism in a naturally infected dog is described by light microscopy and by transmission electron microscopy. Merozoites divided by endodyogeny/merogony. Meronts were crescent/merozoite-shaped and contained a maximum of eight nuclei. A distinctive feature of merozoites was the presence of many PAS-positive amylopectin granules that were absent or rare in immature microgamonts making it possible to distinguish them.

A review of coccidiosis in Old World camels.

Domesticated Old World camels (Camelus dromedarius and C. bactrianus) are important for the economy of several countries in Asia, Africa, and the Arabian Peninsula, and coccidiosis is important as a cause of mortality in juvenile camels. There is confusion concerning the species of coccidian parasites in camels and their life cycles. The objective of the present paper is to review biology of the Eimeria and Cystoisospora species in camels. The following conclusions were drawn. Although five species of Eimeria; E. cameli, E. rajasthani, E. dromedarii, E. bactriani, and E. pellerdyi were named from camels, only E. cameli, E. rajasthani, E. dromedarii have been consistently found in numerous surveys and they are morphologically distinct. We consider E. pellerdyi and E. bacterini as species enquirende/ not valid. E. cameli oocysts are distinctive, dark brown and up to 108 µm long. Its gametogonic stages and oocysts are present in the lamina propria of small intestines; only sexual stages have been confirmed. The remaining species of Eimeria (E. rajasthani and E. dromedarii) in camels are <40 µm long and their endogenous stages are unknown. There is one valid species of Cystoisospora, C. orlovi in camels and is associated with severe disease in young camels, both pastoral and stall fed camels. Camels as young as nine days old can develop severe diarrhea and can die before oocysts are detected in feces. Lesions and endogenous stages are confined to the large intestine. The main lesion is hemorrhagic, diphtheroid to hemorrhagic colitis-associated with sexual stages; asexual stages are unknown. Oocysts are rarely excreted by adult camels, and in low numbers. Therefore, infection in very young camels remains unexplained.

A new species of Cystoisospora Frenkel, 1977 (Apicomplexa: Sarcocystidae) from Oecomys mamorae Thomas (Rodentia: Cricetidae) in the Brazilian Pantanal.

Despite the great diversity of coccidians, to our knowledge, no coccidian infections have been described in Oecomys spp. In this context, we examined Oecomys mamorae Thomas (Rodentia: Cricetidae) from the Brazilian Pantanal for infections with enteric coccidia. Nine individuals were sampled, and one was found to be infected. The oöcysts were recovered through centrifugal flotation in sugar solution. Using morphological and morphometric features, we described a new species of Cystoisospora Frenkel, 1977. Sporulated oöcysts were ovoidal 20.0-29.1 × 16.4-23.2 (26.7 × 21.2) µm and contained two sporocysts, 12.9-19.1 × 9.4-13.9 (16.4 × 12.4) µm, each with four banana-shaped sporozoites. Polar granule and oöcyst residuum were both absent. We documented the developmental forms in the small intestine and described the histopathological lesions in the enteric tract. Our results indicate that the prevalence of Cystoisospora mamorae n. sp. in O. mamorae is low, and tissue damage in the enteric tract is mild, even in the presence of coccidian developmental stages.

Chronic Cystoisospora belli infection in an immunocompetent Myanmar refugee - microscopy is not sensitive enough.

BACKGROUND: Cystoisosporiasis is an opportunistic infection seen more commonly in patients with acquired immunodeficiency syndrome. Although uncommon, Cystoisospora infection can occur in immunocompetent individuals but tend to be benign and self-limiting. Chronic infection however, has been described but diagnosis can often be challenging and requires a high clinical index of suspicion. CASE PRESENTATION: We present a case of delayed diagnosis of Cystoisospora belli (C. belli) in an immunocompetent 28-year-old refugee from Myanmar. She had a history of chronic diarrhea where exhaustive investigations over many years failed to reveal a diagnosis. Cystoisospora belli cysts were finally detected in stool 4 years after investigation commenced, and PCR testing on stored colon biopsies amplified a molecular product with 99 % sequence homology to C. belli. The patient improved promptly with trimethoprim-sulfamethoxazole treatment. CONCLUSION: In the appropriate clinical context we suggest molecular testing for C. belli or an empirical therapeutic trial.

Prevalence of Sarcocystis spp. and Hammondia spp. microcysts in esophagus tissue of sheep and cattle, emphasized on their morphological differences.

Sarcocystis and Hammondia are two obligatory protozoan parasites. These genera belong to cyst-forming coccidia group of the phylum Apicomplexa. They both need two different hosts to complete their life cycles. Felids and canids can act as definitive hosts, while herbivores, such as sheep and cattle, are the most important intermediate hosts. Reports verify that no important disease has been caused by Hammondia spp.; on the other hand, Sarcocystis spp. can cause some severe infectious disease in livestock industry such as abortion. Economic losses are another concern due to carcass condemnation during meat inspection in abattoirs and decrease in the quality and quantity of milk and wool production. Due to the Sarcocystis and Hammondia tissue cysts being similar, the distinction between these different genera is so important. In this study, the prevalence of Sarcocystis and Hammondia in the esophagus tissue of sheep and cattle slaughtered in one of the industrial abattoir in Iran was reported and an easy and rapid method for accurate diagnosing of Sarcocystis and Hammondia bradyzoites was explained.

Hammondia isolated from dogs and foxes are genetically distinct.

Hammondia heydorni is regarded as a protozoan parasite that uses canids, e.g. dogs and foxes, as definitive hosts, but clinical signs of infection are rare. This study therefore took advantage of the opportunity to study an oocyst population from the faeces of a dog suffering from intermittent bouts of diarrhoea. Oocysts from the naturally infected dog were shown to be H. heydorni by using the polymerase chain reaction combined with DNA sequencing as a diagnostic tool. The nucleotide sequence data reported in this paper are available from GenBank under the following Accession numbers DQ183058, DQ183059 and DQ022687. A comparison of the first internal transcribed spacer (ITS1) sequence of ribosomal DNA obtained with those from other dog and fox oocysts, previously regarded as H. heydorni, showed these oocysts contained identical ITS1 sequences. However, the oocyst DNA from the fox and dog differed by the presence/absence of a 9 bp insertion/deletion within intron 1 of the alpha tubulin gene, and this difference was conserved across a number of different oocyst populations from the 2 species of host. A PCR assay was established that takes advantage of this insertion/deletion and is able to differentiate between the 2 oocyst populations. This study therefore provides evidence that H. heydorni oocysts from dogs and foxes represent 2 distinct genetic lineages that can be differentiated using a PCR, which targets the alpha tubulin locus.

Neospora caninum is an invalid species name: an evaluation of facts and statements.

An evaluation of both the formal requirements of the International Rules of Zoological Nomenclature and the scientific reasons for the description of new genera and species shows that the name Neospora caninum is a nomen nudum. The only characteristic criteria for discriminating between the previously described species Hammondia heydorni and the proposed new species N. caninum (i.e. the lack of a parasitophorous vacuole) has been shown to be wrong in many publications. Furthermore, absolutely no criteria were presented as to why a new genus (i.e. Neospora) should be established besides the already existing genera Hammondia, Toxoplasma and Isospora. In addition, recent transmission experiments show that an oocyst isolate (from the faeces of dogs) is morphologically indistinguishable from H. heydorni [synonymous with Isospora bigemina - small form, Isospora heydorni (Tadros and Laarman 1976) and H. heydorni (Tadros and Laarman 1976) Dubey 1977] and is almost identical with respect to molecular biological features with the NC-1 strain of N. caninum.