Diagnosis Of Cryptosporidiosis Research Articles

Intestinal and Pulmonary Cryptosporidiosis in an Infant with Severe Combined Immune Deficiency

SummarySmall intestinal biopsy established the diagnosis of cryptosporidiosis in a 6‐month‐old male infant with severe combined immune deficiency. Scanning and transmission electron microscopy revealed the ultrastructural details of Cryptosporidium in several stages of development within the patient's small intestine. The organism was resistant to all antibiotics used, and the patient died in the 5th month of his illness, despite receiving parenteral alimentation and undergoing thymus trans‐plantation. His clinical course was similar to that of other patients with fatal immune deficiencies and cryptosporidiosis. Autopsy demonstrated organisms attacking the epithelium of the small intestine, pancreatic duct, and bronchioles. Multiple organ involvement in this patient negates the view that Cryptosporidium is site‐specific for a given host or is alimentary‐canal‐specific in humans.

Human cryptosporidiosis: spectrum of disease. Report of six cases and review of the literature.

Although once regarded exclusively as an animal parasite, Cryptosporidium has emerged during the last decade as a cause of diarrhea in humans. Of the 43 cases of human cryptosporidiosis reported, 27 patients in whom either humoral or cell-mediated immune defects were present had chronic protracted diarrhea that was almost invariably unresponsive to therapy and culminated in death. In contrast, 16 patients with intact immune systems had either self-limited disease or were asymptomatic. Animal exposure was almost exclusively recorded in the latter group. During the last six months at University of Texas M. D. Anderson Hospital and Tumor Institute, Houston, gastrointestinal (GI) tract cryptosporidiosis developed in six homosexual men with acquired immune deficiency syndrome (AIDS). The diagnosis of cryptosporidiosis was established histologically in five patients. In four, cryptosporidial oocysts were detected in the stool. In addition to extensive GI tract cryptosporidiosis, two patients had biliary tract involvement. Multiple chemotherapeutic agents failed to control the disease, and five patients eventually died. Cryptosporidiosis should be considered in the differential diagnosis of diarrhea, in animal handlers or in the severely compromised patient, especially one with AIDS, who has chronic protracted diarrhea.