Evaluation of seven commercial antigen detection tests for Giardia and Cryptosporidium in stool samples.

Stool samples from patients with abdominal symptoms were used to evaluate different copro-diagnostic assays for the detection of Giardia and Cryptosporidium. Results from microscopical examination following conventional stool concentration and direct fluorescent-antibody methods were compared with various commercially available immunochromatographic and enzyme immunoassays. Of 220 samples, 45 were positive for Giardia and 17 for Cryptosporidium. For Giardia, the sensitivities obtained by Ridascreen Giardia, Rida Quick Giardia, Rida Quick Combi and Giardia-Strip were 82%, 80%, 80% and 44%, respectively. For Cryptosporidium, the sensitivities obtained by Rida Quick Cryptosporidium, Ridascreen Cryptosporidium, Rida Quick Combi and Cryptosporidium-Strip were 88%, 82%, 82% and 75%, respectively. The specificity of all tests was > or = 98%. Other intestinal parasites were present in 68 samples, but cross-reactions with other protozoan or helminthic parasites were not observed. Overall, the copro-antigen assays were less time-consuming and easier to perform, but were less sensitive than conventional microscopical methods. Thus, these tests might be a useful addition to, but not a substitute for microscopical methods in the diagnosis of travel-associated giardiasis and cryptosporidiosis.

[Human infection with Dicrocoelium dendriticum]. / Humane Infektion mit Dicrocoelium dendriticum.

UNLABELLED: MEDICAL HISTORY AND PHYSICAL EXAMINATION: A 36-year-old German reported having had chronic-relapsing diarrhea, right upper abdominal pain and weight-loss for about two years. His last journey had taken him to Morocco three and a half years ago. The physical examination was unremarkable except for an abdominal tenderness to palpation in the right upper quadrant. LABORATORY: The serum level of bilirubin was slightly raised to 1.13 mg/dl (<1.10 mg/dl) and the level of IgE was raised to 253 U/ml (<100 U/ml). All other laboratory findings were within normal limits. Stool examinations showed eggs of Dicrocoelium dendriticum. The abdominal ultrasound was unremarkable except for mild steatosis. TREATMENT AND COURSE: The patient denied consumption of liver or liver-products within the past weeks. Spurious infection due to eating infected liver could thus be excluded. The patient was treated for dicrocoeliasis with praziquantel (3 x 600 mg/day for three days). Further stool examinations for parasites were negative. Since the patient still had gastrointestinal discomfort, we decided to give a further therapy with triclabendazole (700 mg, single dose). Five weeks after the second treatment the patient was almost free of symptoms and stool examinations for parasites remained negative. CONCLUSION: Dicrocoeliasis can be associated with chronic diarrhea. Stool examinations for parasites are very important in patients with gastrointestinal symptoms.

The effect of chemo-immunotherapy with SDDS, pyrimethamine and anti-toxoplasma serum on toxoplasma gondii cysts in latent infected NMRI mice.

A substantial reduction of brain cyst numbers could be obtained through a six week therapy with SDDS-pyrimethamine combination or a high titer anti-Toxoplasma serum. NMRI mice experimentally infected three months earlier with cyst-forming Toxoplasma strains Witting, Alt or Gail were used. The effectiveness of the treatments could be increased considerably by simultaneous administration of anti-Toxoplasma serum and SDDS-pyrimethamine. A highly significant reduction of brain cyst numbers, upto 65%, could be obtained by using this mode of chemoimmunotherapy. The effectiveness of the treatments used varied amongst the three Toxoplasma strains.

[The effect of toxoplasma antibodies after reinfection with T. gondii. III. Communication: investigations on the question of placental transmission of toxoplasma in immunised pregnant animals (author's transl)]. / Uber die Wirkung von Toxoplasma-Antikörpern auf T. gondii nach Reinfektion. III. Mitteilung: Untersuchungen über die Frage des plazentaren Ubergangs der Toxoplasmen bei immunisierten trächtigen Versuchstieren.

Investigations on whether theprotective effects of maternal defence mechanisms against T. gondii could prevent a placental transmission of the parasite to the foetus were carried out on pregnant rabbits and mice. With rabbits which were infected 6 to 1 month before the conception and showed a high infection immunity, there was never a transmission to the foetus and likewise at no time after reinfection of such maternal animals during the pregnancy. In mice which were latent infected with 11 different Toxoplasma strains, placental transmission succeeded with only 6 strains intrauterine infection of the foetuses were confirmed in 1 to 3%. After active immunisation of rabbits with non-multiplying antigen before the conception and later primary infection during the pregnancy, intrauterine transmission to the foetus could be detected in 55%. After passive immunisation with hyperimmune serum, infected foetuses could be ascertained in 79% of rabbits and 24% of mice. Possible intrauterine transmission to foetus protected by maternal defence mechanisms is likely to be dependent on various factors. 1. On the host species, 2. the state of immunity (infection immunity), 3. on Toxoplasma strain. An infection immunity with the presence of living parasites in maternal organism is probably dependent on Toxoplasma strain in mice and offers in rabbits an apparently certain protection against congenital infection. On the contrary, serologically detectable humoral antibodies after active or passive immunisation do not prevent a transplacental transmission. On the basis of experimental findings it has been concluded that at least the immunoglobulins of type IgG, IgA and IgM in lower titer ranges offer no protection against congenital transmission after reinfection during pregnancy. Also, the protective effect can not be based on the structure of respective placenta. The roles of cellular immune defence and other possible factors in this connection are discussed.