Cryptosporidium-induced acute kidney injury in the setting of acquired immunodeficiency syndrome.

Cryptosporidium is a pathogen that can cause infectious enteritis especially in immunocompromised patients. Acute kidney injury, electrolyte imbalance, and acid-base disorders may occur as a result of high volumes of intestinal fluid loss, which has not been previously reported to be a common manifestation of cryptosporidiosis. Numerous antigen detection methods can be used to ensure early diagnosis of Cryptosporidium infection, which is crucial to prevent morbidities. We report a unique case of cryptosporidiosis in a 33-year-old male patient with acute kidney injury and profound hypokalemia, hyponatremia, hypocalcemia, hypophosphatemia, hypomagnesemia, and metabolic acidosis. Following the initiation of antiretroviral therapy to human immunodeficiency virus, the patient's symptoms improved and he recovered fully from kidney injury and electrolyte imbalance, highlighting the importance of early antiretroviral therapy.

Prevalence of Cryptosporidium and microsporidial infection in HIV-infected individuals.

BACKGROUND: Microsporidia and Cryptosporidium are obligate intracellular protozoa. These medically important species are recognized as opportunistic organisms in intestinal complications in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome patients. METHODS: The current cross-sectional study was designed and conducted from August 2016 to August 2017 to determine intestinal Cryptosporidium and microsporidia spp. in HIV-infected individuals from the Behavioral Diseases Counseling Center, Tabriz, Iran, by modified acid-fast and modified trichrome staining and nested polymerase chain reaction (PCR) and real-time PCR. RESULTS: Of 100 HIV-infected persons, 21.0% (95% confidence interval [CI] 13.0 to 30.0) and 18.0% (95% CI 11.0 to 26.0) were identified as Cryptosporidium and microsporidia, respectively, by the microscopic method. Of these 100 HIV-infected persons, 18.0% (95% CI 11.0 to 26.0) and 14.0% (95% CI 7.0 to 22.0) were positive for Cryptosporidium and microsporidia, respectively, by the molecular method. The predominant species of microsporidia in patients was Enterocytozoon bieneusi (85.7% [95% CI 57.0 to 98.0]) and Encephalitozoon cuniculi (14.3% [95% CI 1.7 to 42.0]), which were found by quantitative real-time PCR and its high-resolution melting tool. CONCLUSIONS: As far as we know, this study is the first to estimate the prevalence of infection with Cryptosporidium and microsporidia among HIV-infected persons in northwest of Iran. The prevalence of intestinal microsporidiosis and cryptosporidiosis in this area in HIV-infected people was higher than the global prevalence of infection among immunocompromised patients. In addition to the need for further studies to prove protozoan pathogenicity in the aforementioned group, preventive measures should be considered.

IgA Vasculitis in an Adult Linked to Cryptosporidium and Giardia Co-Infection: A Comprehensive Case Study.

BACKGROUND Immunoglobulin A (IgA) vasculitis is a small-vessel vasculitis characterized by the deposition of IgA immune complexes primarily in the skin, kidneys, and gastrointestinal tract. While it predominantly affects children, cases in adults are associated with more severe manifestations. Evidence suggests that infectious triggers play a pivotal role in its etiology. Often, it follows a self-limiting course and doesn't necessitate intervention. CASE REPORT We present the case of a 51-year-old man who presented with a maculopapular rash, arthralgia, and abdominal pain. An examination revealed a purpuric rash on lower extremities and abdomen. A lower extremity duplex ultrasound identified deep vein thrombosis (DVT) in the right leg. Skin biopsy of the rash confirmed the diagnosis of IgA vasculitis, demonstrating perivascular neutrophilic infiltrate and IgA complex deposition. Stool studies revealed co-infection with Cryptosporidium and Giardia. The patient was treated with a prednisone taper with significant improvement in symptoms. CONCLUSIONS This case highlights the potential role of Cryptosporidium as a trigger for IgA vasculitis. The presence of concurrent infections underscores the complex interplay between infections and the development of IgA vasculitis. The co-infection with Giardia suggests that a secondary infection may be involved, further complicating the disease's etiology. The observation of DVT suggests a possible link between IgA vasculitis and a prothrombotic state. This report serves to expand the knowledge of IgA vasculitis triggers and associated complications, guiding clinicians in diagnosing and managing similar cases while emphasizing the importance of vigilance in adults with these symptoms.

Microscopia e Ensaio de Imunoabsorção Enzimática: detecção de Cryptosporidium spp. em fezes de crianças moçambicanas / Microscopy and Enzyme-Linked Immunosorbent Assay for Cryptosporidium spp. detection in diarrheic feces of Mozambican children

A diarreia causada por Cryptosporidium spp. é comum em crianças e culmina com elevadas taxas de morbi-mortalidade, sobretudo nos países em desenvolvimento. A técnica convencional para o diagnóstico de Cryptosporidium spp. é a microscopia óptica, contudo, o Ensaio de Imunoabsorção Enzimática (ELISA) também tem sido usado. O objectivo deste estudo foi de comparar a performance do ELISA (ensaio comercial) em relação a microscopia óptica na detecção de Cryptosporidium spp. em fezes diarreicas de crianças admitidas no Hospital Geral de Mavalane (HGM) de Maio de 2014 a Fevereiro de 2015. No total, 130 amostras de fezes foram testadas, primeiramente por microscopia óptica e depois por ELISA. A estatística descritiva, sensibilidade, especi cidade e valores preditivos negativo e positivo foram usados para analisar os dados.A microscopia permitiu a identi cação de Cryptosporidium spp., Entamoeba hystolitica/díspar/moshovskii, Giardia intestinalis, Ascaris lumbricóides, Trichuris trichiura e Balantidium coli. Doze (9.2%) amostras foram positivas para Cryptosporidium spp., contra 22 (16.9%) identi cadas por ELISA. Esta diferença foi estatisticamente signi cativa (p = 0.002). A frequência de detecção deste patógeno por microscopia foi maior em crianças dos 12 aos 23 meses (4.6%), enquanto por ELISA foi maior em crianças dos zero aos 11 meses. A sensibilidade do ELISA na detecção de antígenos de Cryptosporidium spp. foi de 58.3%, enquanto a especi-cidade foi de 81.4%. Os resultados encontrados ressaltam a necessidade de uma ferramenta de diagnóstico complementar tal como o ELISA, para con rmar o diagnóstico em pacientes com sinais clínicos típicos de criptosporidiose mas com resultado negativo por microscopia.

Diarrhea caused by Cryptosporidium spp. is common in children and ends with high morbidity and mortality rates, mostly in developing countries. e conventional technique for the diagnosis of Cryptosporidium spp. is the optical microscopy, however, the Enzyme-linked immunosorbent assay (ELISA) is also being implemented. e aim of this study was to compare the performance of ELISA (commercial immunoassay) in relation to optical microscopy to detect Cryptosporidium spp. in diarrheic feces of children admitted to Mavalane General Hospital from May 2014 to February 2015. Overall 130 stool samples were tested rstly by optical microscopy and then by ELISA. Descriptive statistics, sensitivity, speci city, negative and positive predictive value were used to analyze the data. e microscopy detected 12 (9.2%) Cryptosporidiumspp., positive samples and ELISA identi ed 22 (16.9%). is di erence was statistically signi cant (p = 0.002). e frequency of detection by microscopy was higher in children from 12 to 23 months (4.6%), while by ELISA was higher in those from zero to 11 months. e microscopy enabled the identi cation of other parasites such as Entamoeba hystolitica/díspar/moshovskii, Giardia intestinalis, Ascaris lumbricóides, Trichuris trichiura and Balantidium coli. e sensitivity of the ELISA in detection of Cryptosporidium spp. antigens was 58.3%, while the speci city was 81.4%. Taking all together, our results highlight the need of a complementary diagnostic tool, such as this ELISA, to con rm the diagnosis in patients with typical clinicalsymptoms of cryptosporidiosis but negative results by microscopy.

Diarrea y desnutrición en paciente trasplantado renal: un caso de infección por criptosporidiosis / Diarrhea and malnutrition in kidney transplant recipient: A case of infection by cryptosporidiosis

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Infección por Cryptosporidiumparvum en un receptor de trasplante renal / No disponible

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AIDS-related gastric cryptosporidiosis simulating malignancy

La localización del Cryptosporidium en el estómago es infrecuente. Se presenta el caso de un paciente de 56 años de edad, VIH-positivo, con inmunosupresión severa, después de abandonar el tratamiento anti-retroviral, que presentó malestar epigástrico, náuseas y vómitos. La TC abdominal con contraste mostró un engrosamiento concéntrico importante del antro gástrico. La evaluación endoscópica gastrointestinal reveló falta de distensibilidad de la pared gástrica y marcado engrosamiento, junto con rigidez, distorsión y erosión de los pliegues de la mucosa del antro. El estudio endoscópico fue informado como proceso maligno sugestivo de linfoma. El diagnóstico histopatológico fue de criptosporidiosis. De acuerdo con nuestro conocimiento, la criptosporidiosis gástrica simulando un tumor maligno no ha sido descrita (AU)

Cryptosporidium localization to the stomach is uncommon. We report a case of a 56-year-old, HIV-positive, male patient with severe immunosuppression after antiretroviral treatment dropout who presented with epigastric discomfort, nausea and vomiting. The abdominal CT with contrast showed an important concentric thickening of the gastric antrum wall. Upper gastrointestinal endoscopic evaluation revealed lack of distensibility of the gastric wall and marked thickening, stiffness, distortion, and erosions of mucosal folds involving the antrum region. The endoscopy was clinically reported as gastric malignancy suggestive of lymphoma. The histopathologic diagnosis was cryptosporidiosis. To our knowledge, gastric cryptosporidiosis simulating malignancy has not been previously described. This type of lesion should be included in the differential diagnosis of AIDS patients with lesions simulating gastric malignancy (AU)

Criptosporidiose: uma revisão sobre a sua implicação na conservação dos mamíferos aquáticos / Cryptosporidiosis: a review about its implication in conservation of aquatic mammals

A criptosporidiose é uma doença parasitária emergente que vem sendo relatada em diversas espécies de mamíferos, incluindo os aquáticos. Esta revisão trata da epidemiologia da infecção por Cryptosporidium spp. em mamíferos aquáticos. A idade dos animais, dose infectante e o estado imunológico podem influenciar na apresentação clínica, e quando associados a outros patógenos pode levar o animal a óbito. A contaminação dos recursos hídricos constitui um dos principais meios de disseminação do parasito, que foi identificado por diferentes técnicas de análise. A adequação das estruturas de saneamento, utilização de métodos apropriados para a inativação dos oocistos e garantia das normas de higiene pessoal constituem algumas das maneiras recomendadas para minimizar a disseminação do Cryptosporidium entre os mamíferos aquáticos.

Cryptosporidiosis is an emerging parasitic disease that has been related in several mammal species, including the aquatic ones. This review covers the epidemiology infection by Cryptosporidium spp. in aquatic mammals. The age of the animal, infecting dose and immunological state can influence on the clinical presentation, and when associated with other pathogen, can lead the animal to death. The water supply contamination is water supply is one of the major ways of the pathogen dissemination, which was being identified by different techniques of laboratorial analysis. The adequacy of sanitation structures, the use of appropriate method to inactivate the oocysts and the assurance of personal hygiene norms are some of the recommended way to minimize the dissemination of Cryptosporidium among aquatic mammals.

Colitis por Cryptosporidium como forma de presentación en un paciente con síndrome de inmunodeficiencia adquirida / Colitis by Cryptosporidium as initial manifestation of acquired immunodeficiency syndrome

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Criptosporidiose em crianças de 1 a 2 anos de idade, com diarréia aguda em Belém, Pará, Brasil / Cryptosporidiosis in children (1-2 years old) with acute diarrhoea from Belém, Pará, Brazil

Num período de 12 meses, 201 espécimes fecais de 61 crianças foram examiandos com vista a detecçäo de Cryptosporidium. Cento e quinze espécimes foram obtidos durante os episódios diarréicos e 86 de crianças sem diarréia (grupo controle). Todos os espécimes fecais foram examinados pelo método de coloraçäo de Ziehl-Neelsen modificado

Intestinal cryptosporidiosis: association with Pneumocystis carinii, cytomegalovirus and Candida sp. infections

Trata-se de apresentaçäo de um caso de criptosporidiose intestinal diagnosticada histologicamente em material de autópsia. A paciente era uma criança de 5 meses, internada com diarréia aguda grave, associada a pneumonia por Pneumocystis carinii, sialadenite citomegálica e candidíase oral e cutánea. A presença de infecçöes oportunísticas múltiplas indicaram o diagnóstico de imunodeficiência. Cryptosporidium sp é uma possibilidade etiológica para diarréias agudas em pacientes imunodeprimidos ou imunocompetentes e deve ser procurado em material de autópsia quando näo diagnosticado "in vivo"

Enteritis por Cryptosporidium en un paciente leucémico / Enteritis by Cryptosporidium in a leukemic patient

Se analiza el caso de un paciente de 2 años 7 meses con leucemia linfoblástica, que fue tratada con quimioterapia y radioterapia obteniéndose remisión de su enfermedad. Durante el sexto mes de tratamiento comenzó a sufrir diarrea con deposiciones profusas, 3 a 4 veces al día, y vómitos, sin fiebre: esta se prolongó durante 3 meses comprometiendo en forma importante el peso corporal y no respondió a tratamiento dietético ni a la administración de antimicrobíanos (Cotrimoxazol y Furazolidona). Se descartó el síndrome de malabsorción. Los exámenes de deposiciones fueron negativos para los enteroparásitos habituales (técnica de PAFS). Tampoco se recuperaron bacteria enteropatógenas (E. coli enteropatógenos serogrupos clásicos e invasores Shigella, Salmonella, Yersinia, Aeromonas y Campylobacter). Se comprobó infección por Cryptosporidium mediante tinción de Ziehl-Neelsen en frontis de 2 muestras de deposición. La paciente fue tratada con Eritromicina 50 mg x kg x día, durante 10 días, con excelente respuesta. Se analizan las técnicas de diagnóstico y posibilidades terapéuticas

Cryptosporidiosis: estudios en niños de comunidades de nivel socioeconómico bajo / Cryptosporidiosis: studies in children of low socieconomic level communities

Se detectó Cryptosporidium en 2 (1,5%) de 132 lactantes con diarrea aguda, en 2 (3,2%) de 63 lactantes con diarrea persistente, en 1 (3,9%) de 26 lactantes desnutridos con diarrea aguda y en 7 (1,4%) de 516 pacientes pediátricos ambulatorios que consultaron por diarrea aguda o crónica o dolor abdominal recurrente. Se presentan las historias de los 5 pacientes con Cryptosporidium detectados en los primeros tres estudios. El compromiso del estado nutricional, la evolución tórpida de los cuadros y las infecciones a repetición son elementos clínicos sugerentes de inmunodeficiencia. En uno de ellos las concentraciones séricas de IgG e IgA la subpoblación de linfocitos T auxiliares y supresores estaban dentro de los límites normales. En los demás pacientes, todos con diarrea prolongada, no se hicieron estudios de inmunidad

X-linked Hyper-IgM Syndrome Associated with Cryptosporidium parvum and Cryptococcus neoformans Infections: the First Case with Molecular Diagnosis in Korea

X-linked hyper-IgM syndrome (XHIM) is a rare primary immunodeficiency disorder, caused by mutations of the gene encoding CD40 ligand (CD40L; CD154). We report the clinical manifestations and mutational analysis of the CD40L gene observed in a male patient from a XHIM family. Having hypogammaglobulinemia and elevated IgM, the 3-yr-old boy exhibited the characteristic clinical features of XHIM. The patient suffered from frequent respiratory infections, and chronic enteritis caused by Cryptosporidium parvum. In addition, a lymph node biopsy and a culture from this sample revealed C. neoformans infection. Activated lymphocytes from the patient failed to express CD40L on their surface as assessed by flow cytometry and a missence mutation (W140R) was found at the XHIM hotspot in his CD40L cDNA to confirm the diagnosis. Genetic analysis of the mother and sister showed a heterozygote pattern, indicating carrier status. To our knowledge, this is the first report on the molecular diagnosis of an XHIM patient in Korea.

Cryptosporidiosis humana: características clínicas de 11 casos / Human cryptosporidiosis: clinical characteristics of 11 cases

Cryptosporidium sp. es un coccidio productor de diarrea crónica en inmunocomprometidos y de diarrea aguda en niños y adultos inmunocompetentes. Se describen las características clínicas de 11 pacientes infectados con Cryptosporidium sp. Todos eran menores de 5 años de edad y 10 de ellos cursaron con diarrea aguda, que se caracterizó por deposiciones líquidas y frecuentes, con abundantes mucosidades, de evolución prolongada y tendencia a la deshidratación y acidosis metabólica. No se observaron leucocitos fecales ni eosinofilia en forma significativa. Hubo una alta frecuencia de patologías concomitantes a la infección por Cryptosporidium sp. Entre ellas destacó la desnutrición

Criptosporidiosis humana en el Ecuador / Human cryptosporidiosis in Ecuador

Presentamos el primer reporte de criptosporidiosis humana asociado con diarrea en Quito, Ecuador. Utilizando la técnica de DMSO-ácido-resistente, hemos podido demostrar la presencia de oocitos de Criptosporidium asociado con dos casos de gastroenteritis aguda. Es importante que se considere a este parásito como posible agente etiológico en diarreas de inicio agudo, prolongadas y acuosas con una mayor frecuencia en los niños. De ahí que recomendamos la búsqueda rutinaria de este parásito en todos los laboratorios clínicos

Criptospiridiasis respiratoria en un paciente con SIDA

Se presenta un paciente colombiano, adulto de sexo masculino, con diagnóstico de SIDA, que presentó enfermedad entérica y pulmonar causada por Cryptosporidium. Se discute diferentes aspectos relacionados con la criptosporidiosis humana y se comparan con lo informado en la literatura médica

Gastritis erosiva asociada a criptosporidium en dos pacientes con SIDA / Erosive gastritis associated to the cryptosporidium in 2 patients with AIDS

La aparición de vómitos y diarrea en pacientes con síndrome de inmunodeficiencia adquirida ha sido atribuido frecuentemente a organismos enteropatógenos que invaden el tracto gastrointestinal como consecuencia del trastorno inmunológico del huésped. El cryptosporidium ha sido detectado con alguna prevalencia y su localización predominante es el tracto gastrointestinal, a pesar que otros sitios han sido notificados. Se presentan dos casos con diagnóstico endoscópico de gastritis congestiva-erosiva con presencia de criptosporidium en las biopsias gástricas. Ambos pacientes cursaban un estadío terminal de su enfermedad (AU)

Gastroduodenite erosiva associada a Cryptosporidium num paciente com síndrome de imunodeficiência adquirida / Erosive gastroduodenitis associated with Cryptosporidium in a patient with acquired immunodeficiency syndrome

É relatado um paciente com a síndrome de imunodeficiência adquirida, diarréia e vômitos persistentes. Esofagogastroduodenoscopia com biopsias da mucosa esofágica, gástrica e duodenal revelou gastroduodenite erosiva com presença de Cryptosporidium sp. Exames proctológico mostrou um quadro de proctite e a biopsia retite crônica inespecífica com presença de Cryptosporidium sp