Gastric Cryptosporidiosis Research Articles

Eradication of AIDS-related gastric cryptosporidiosis with azithromycin

Human cryptosporidiosis is a protozoan infection that can produce severe debilitating disease in immunocompromised patients, especially those with AIDS. The efficiency of different treatments is limited and there is no uniform therapy. We report a case of eradication of AIDS-related cryptosporidiosis with azithromycin and discuss new treatment regimens reported in the literature.

Gastric cryptosporidiosis: correlation between intensity of infection and histological alterations.

A retrospective study was carried out to determine the histopathological alterations of the gastric mucosa associated with the presence of Cryptosporidium parasites in the stomach. Gastric biopsies from eight patients with AIDS and cryptosporidiosis were reviewed. Most individuals were males (7/8, mean age 34.7 years) intravenous drug users (6/8), with very low peripheral blood CD4 lymphocyte counts (< 150/mm3; mean 56/mm3). Endoscopic examination showed no significant mucosal abnormalities in half of the individuals; inflammation was observed in the other four individuals and was associated with erosions in two cases. The lesions observed (reactive changes, oedema, erosions, etc.) are not pathognomonic, since they are seen in most common acute and chronic gastrititis of various aetiologies (toxic, infectious, mechanical). The histological examination showed Cryptosporidium parasites in the antrum-pylorus of all examined persons, whereas only two of them had parasites in the corpus. Modifications of histological features consisted mostly of hyperplastic reactive changes of the gland epithelial and inflammation in the connective tissue of the lamina propria. No clear correlation was found between endoscopy and histological findings, whereas a close correlation between intensity of the infection and degree of histological alterations was observed. These findings suggest that, in individuals with AIDS, cryptosporidiosis and severe immunodepression, upper endoscopy with random gastric biopsies should be performed, even in the absence of endoscopically appreciable lesions. The diagnosis of gastric cryptosporidiosis has to rely on histological findings, and pathologists must be aware of the fact that Cryptosporidium parasites are mainly found in areas showing reactive hyperplasia.

A clinicopathologic analysis of AIDS-related cryptosporidiosis.

To characterize the histology of AIDS-associated cryptosporidiosis and identify features that explain the clinical variability. A retrospective analysis of HIV-positive individuals with cryptosporidiosis who underwent endoscopy at the Johns Hopkins Hospital between 1985 and 1996. The histologic features (intensity of Cryptosporidium infection, inflammation, mucosal damage, copathogens) of gastrointestinal biopsies from 37 HIV-positive individuals with cryptosporidiosis were systematically graded. These histologic features were correlated with the severity of the diarrheal illness obtained from a patient chart review. Histologic features associated with Cryptosporidium infection include a neutrophilic infiltrate in the stomach, villus blunting in the duodenum, cryptitis and epithelial apoptosis in the colon, and reactive epithelial changes in the stomach and duodenum. The nature and intensity of the inflammatory response varied widely; however, duodenal biopsies from a subset of patients (37%) revealed marked acute inflammation that was associated with concomitant cytomegalovirus infection. Although duodenal infection was common (93% of individuals), infection of other sites was variable (gastric cryptosporidiosis in 40% and colonic cryptosporidiosis in 74%). Widespread infection of the intestinal tract, which included both the large and small intestine, was associated with the most severe diarrheal illness. Cryptosporidium infection produces histologic evidence of gastrointestinal mucosal injury. The inflammatory response to the infection is variable, and may be modified by copathogens such as cytomegalovirus. The clinical manifestations are influenced, in part, by the anatomic distribution of the infection, with extensive infections involving both small and large intestines producing the most severe illness.

Gastric Cryptosporidiosis in Juvenile Red Drum

Abstract Pond-reared fingerling red drum Sciaenops ocellatus experiencing low mortality were found to be in poor physical condition. Histopathology revealed numerous 2–5-μm spherical organisms lining the gastric microvillus border and clusters of 4–7-μm organisms within epithelial cell cytoplasmic vacuoles suggestive of cryptosporidiosis. The diagnosis was confirmed by electron microscopy, with which life cycle stages were observed to be compatible with criteria established for Cryptosporidium spp. inother fish. Although few pathologic changes have been attributed to cryptosporidial infections in fish, a moderate inflammatory response in these red drum was elicited by the parasite in association with disruption of the normal tissue architecture, epithelial necrosis, and glandular loss. Ancillary diagnostic tests, including bacteriology and parasitology, were negative. The possible contribution of this organism to mortalities seen in these fish is discussed.

Gastric cryptosporidiosis of feeder cattle, beef cows, and dairy cows

Cryptosporidium infection in cattle is discussed, with emphasis on its diagnosis by acid-fast faecal smear.