ABSTRACT
This is the report on a patient with chronic diarrhea caused by microsporidia. He is married, infected with HIV and has low CD4 cell count. The diagnosis was established through stool parasite search using concentration methods and Gram - chromotrope staining technique. Ileum biopsy was also performed in this case. The etiological diagnosis may be established in a clinical laboratory, by chromotrope staining technique in routine microscopic examination of stool specimens.
Este é o relato de caso de doente com diarréia crônica causada por Microsporidia. O doente era homem, casado, infectado com HIV e tinha baixa taxa de linfócitos CD4+. O diagnóstico foi feito em exame de fezes utilizando métodos de concentração e técnica de coloração de Gram-Chromotrope. Biópsia de íleo também foi realizada neste caso. O diagnóstico etiológico pode ser feito em laboratório clínico, por técnicas de coloração baseada em cromotrope na rotina da observação microscópica direta.
Subject(s)
Humans , Male , Adult , AIDS-Related Opportunistic Infections/complications , Diarrhea/microbiology , Microsporidia/isolation & purification , Microsporidiosis/complications , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , Chronic Disease , Feces/microbiology , Hospitals, University , Microsporidiosis/diagnosis , Microsporidiosis/drug therapy , Staining and LabelingABSTRACT
UNLABELLED: A number of species of Cryptosporidium are associated with diarrhea worldwide. Little data exists regarding the genotypes and species of Cryptosporidium associated with cases of infections in Brazil. PURPOSE: In the present study, we ascertained by molecular methods the species and the genotype of Cryptosporidium sp from a diarrhea outbreak diagnosed in a day care at the Hospital Clínicas, São Paulo University Medical School. MATERIALS AND METHODS: Specific identification and typing of the isolates associated with the outbreak was done by DNA sequencing analysis of fragments amplified by polymerase chain reaction (PCR) from 3 different Cryptosporidium loci: the SSUrRNA coding region, the Cryptosporidium oocyst wall protein (COWP) gene, and the microsatellite locus 1 (ML1), a tandem GAG-trinucleotide repeat containing substitutions that differentiate the genotypes of Cryptosporidium parvum and Cryptosporidium hominis. RESULTS: A total of 29 positive samples from the outbreak were studied by the molecular methods described. Our study revealed the presence of a single genotype of Cryptosporidium hominis in all samples. CONCLUSION: The molecular analysis reinforced the hypothesis that the transmission of Cryptosporidium hominis during the period the samples were collected occurred in an outbreak pattern, possibly by person-to-person contact through the fecal-oral route. As far as we know, this is the first time that molecular tools have been used to identify the species and the genotype of isolates showing the presence of the ML1 genotype in samples from Brazilian patients.
Subject(s)
Cryptosporidiosis/parasitology , Cryptosporidium/genetics , Diarrhea/parasitology , Animals , Brazil/epidemiology , Child Day Care Centers , Child, Preschool , Cryptosporidiosis/epidemiology , Diarrhea/epidemiology , Diarrhea/genetics , Disease Outbreaks , Female , Genotype , Humans , Infant , Male , Risk FactorsABSTRACT
Mundialmente, diferentes espécies de Cryptosporidium estão relacionadas com doenças diarréicas. No Brasil há poucos dados sobre os genótipos das espécies de Cryptosporidium associadas a infecções. OBJETIVO: No presente estudo, caracterizamos, por métodos moleculares, a espécie e o genótipo de Cryptosporidium sp diagnosticado em surto diarréico ocorrido na creche do Hospital das Clínicas, São Paulo, Brasil. MATERIAL E MÉTODOS: Identificação específica e tipagem dos isolados associados ao surto foram feitos a partir do seqüenciamento de fragmentos de DNA amplificados por PCR dos seguintes loci: a região que codifica o SSUrRNA, o gene que codifica uma proteína do envoltório dos oocistos de Cryptosporidium (COWP), e o locus de microsatélite ML1, representado por seqüências repetitiva de três nucleotídeos GAG contendo substituições que diferem entre os genótipos de Cryptosporidium parvum e Cryptosporidium hominis. RESULTADOS: Um total de 29 amostras positivas para Cryptosporidium associadas ao surto diarréico foi analisado com base nos métodos moleculares acima descritos. O estudo revelou a presença do genótipo ML1 de Cryptosporidium hominis. DISCUSSÃO: A análise molecular reforçou a hipótese de que a transmissão de Cryptosporidium hominis durante o surto diarréico ocorreu de pessoa a pessoa através da rota fecal oral. Esta é a primeira vez que ferramentas moleculares são utilizadas para identificação de espécies e genótipos de isolados acusando a presença do genótipo ML1 em pacientes brasileiros.
Subject(s)
Humans , Animals , Male , Female , Infant , Child, Preschool , Cryptosporidiosis/parasitology , Cryptosporidium/genetics , Diarrhea/parasitology , Brazil/epidemiology , Child Day Care Centers , Cryptosporidiosis/epidemiology , Disease Outbreaks , Diarrhea/epidemiology , Diarrhea/genetics , Genotype , Risk FactorsABSTRACT
This is the report on a patient with chronic diarrhea caused by microsporidia. He is married, infected with HIV and has low CD4 cell count. The diagnosis was established through stool parasite search using concentration methods and Gram-chromotrope staining technique. Ileum biopsy was also performed in this case. The etiological diagnosis may be established in a clinical laboratory, by chromotrope staining technique in routine microscopic examination of stool specimens.
Subject(s)
AIDS-Related Opportunistic Infections/complications , Diarrhea/microbiology , Microsporidia/isolation & purification , Microsporidiosis/complications , AIDS-Related Opportunistic Infections/drug therapy , Adult , Chronic Disease , Feces/microbiology , Hospitals, University , Humans , Male , Microsporidiosis/drug therapy , Staining and LabelingABSTRACT
Cyclospora cayetanensis causes watery diarrhea in tropical countries, among travelers and after ingestion of contaminated water and food. Very little is known about its epidemiology, pathogenic aspects and reservoirs. In Brazil, its prevalence is unknown and to date there have been reports of three outbreaks. We report here a retrospective study of 5,015 stool samples from 4,869 patients attended at Clinical Hospital of the University of São Paulo Medical School, SP, Brazil between April 1996 and January 2002, with 14 cases of Cyclospora cayetanensis being detected there was a prevalence of 0.3%. Of the 14 infected patients, the mean age was 38 years and 71.4% were female. Ten patients presented symptoms; six presented levels of immunological markers and five patients were immunodeficient.
Subject(s)
Cyclospora/isolation & purification , Cyclosporiasis/epidemiology , Diarrhea/epidemiology , Feces/parasitology , Adult , Animals , Biomarkers , Brazil/epidemiology , Cyclosporiasis/diagnosis , Diarrhea/parasitology , Female , Humans , Male , Middle Aged , Prevalence , Retrospective StudiesABSTRACT
Cyclospora cayetanensis causa diarréia líquida em países tropicais, viajantes e após ingestão de água e alimentos contaminados. Muito pouco é conhecido sobre sua epidemiologia, aspectos patogênicos e reservatórios. No Brasil, sua prevalência é desconhecida com relato de três surtos. Nós relatamos um estudo retrospectivo de 5.015 amostras fecais provenientes de 4.869 pacientes atendidos no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil entre abril de 1996 e janeiro de 2002 com detecção de 14 casos de ciclosporíase e prevalência de 0,3%. Deste total 71,4% eram do sexo feminino com idade média de 38 anos. Dez apresentaram sintomatologia, seis tinham níveis de marcadores imunológicos e cinco imunodeficiência.
