Kinyoun Acid-fast Stain Research Articles

Enteroparasitism and Risk Factors Associated with Clinical Manifestations in Children and Adults of Jalisco State in Western Mexico.

ObjectivesTo determine the prevalence and risk factors associated with intestinal parasites in the population of San Juan Cosala, Jalisco, Mexico.MethodsA total of 277 samples from 104 participants were analysed using direct smear, flotation, formaldehyde/ethyl acetate, and modified Kinyoun’s acid-fast stain methods. The Graham method was applied only for samples from children under 12 years of age for the diagnosis of Enterobius vermicularis.ResultsThe prevalence of parasite infections in the study population was 77.9% including: Entamoeba histolytica/E. dispar/E. moshkovskii/E. bangladeshi (37.5%), Giardia intestinalis (11.5%); commensals: Endolimax nana (44.2%), Entamoeba coli (27.9%), Chilomastix mesnili (6.7%) and Iodamoeba bütschlii, (2.9%); emerging intestinal protozoans: Blastocystis spp. (49%), Cryptosporidium spp. (7.7%) and Cyclospora cayetanensis (2.9%); and helminths: Enterobius vermicularis (18.3%) and Ascaris lumbricoides (5.8%). The results also showed that 58.64% of the studied population presented polyparasitism. A significant association was found between protozoan infections and housewives, and houses that were not built with concrete ceilings, brick walls and cement floors (p < 0.05).ConclusionPolyparasitism was observed in over half the study population. The most prevalent parasite was Blastocystis spp, whilst the prevalence of helminths was less than that of protozoans. The risk factors for infection to intestinal parasites were being a housewife and not having solid brick, cement and concrete materials for house construction.

Outbreak of Microsporidial Keratoconjunctivitis Associated With Water Contamination in Swimming Pools in Taiwan

To report an outbreak of microsporidial keratoconjunctivitis resulting from a swimming pool in Taiwan. Retrospective case series. The records of 13 teenagers (15 eyes) contracting microsporidial keratoconjunctivitis after swimming in a local swimming pool were reviewed. Corneal scrapings were collected in all eyes at a tertiary referred hospital in June 2017. Gram stain, modified Kinyoun acid-fast stain, polymerase chain reaction (PCR), and gene analysis of the microsporidian 16S ribosomal RNA (rRNA) were examined in all 15 cases. Symptoms occurred 1-12days after the water contact. At presentation, all eyes showed nonpurulent conjunctivitis and small, plaque-like epithelial lesions peripherally (n= 6), centrally (n= 3), both peripherally and centrally (n= 5), or centrally with superficial punctate keratopathy (n= 1). During the follow-up period, 10 eyes developed central superficial punctate keratopathy (n= 6) or subepithelial haze or infiltrates, which were distributed centrally (n= 2) or peripherally (n= 3), following development of plaque-like epithelial lesions. The results of Gram stain and modified Kinyoun's acid-fast stain were confirmatory in 10 cases (67%). All 15 cases yielded positive PCR results and were all identified to be Vittaforma corneae. All followed-up eyes healed without sequelae using topical levofloxacin and betamethasone eye drops. Microsporidial keratoconjunctivitis can develop from contact with swimming pool water. The clinical course initially manifested as rapidly resolving conjunctivitis and peripheral plaque-like epithelial lesions, followed by paracentral or central plaque-like epithelial lesions, which evolved into subepithelial haze or infiltrates.

Molecular identification of Buxtonella sulcata from associated-diarrhea in water buffaloes (Bubalus bubalis) in the Philippines

Sixty suspected protozoan oocysts were demonstrated from 260 fecal samples collected from water buffaloes aged one month to seven years old with clinical signs of diarrhea in four provinces in the Philippines after conventional methods of isolation, sporulation, morphological characteristics and Kinyoun Acid Fast Staining techniques. The recovered protozoan oocysts were subjected to molecular analysis. Amplification of DNA extracted from recovered Eimeria oocysts using universal primers for the ITS-1 region of 18S rRNA revealed PCR products with 348 bp size demonstrated by samples collected from Benguet, La Union and Nueva Ecija provinces in the Philippines while DNA extracted from oocysts of suspected Cryptosporidium spp. samples that applied primers for the SSU of 18S rRNA registered PCR products but no genes were amplified from diarrheic water buffaloes from these provinces. Alignment of the DNA sequences of the suspected Eimeria and Cryptosporidium species revealed sequences for three isolates of Buxtonella sulcata with product lengths that varied from 235 to 252 bp. This is an initial observation on the involvement of B. sulcata in diarrhea condition of water buffaloes in the Philippines. Phylogenetic analysis of the three local isolates of B. sulcata revealed no similarity with other protozoan constructed according to Neighbor-Joining method.

Detection of Cryptosporidium parvum DNA in fecal samples of infected cattle (Bos indicus) and water buffaloes (Bubalus bubalis) in the Philippines using loop mediated isothermal amplification method

Fecal DNA samples from 17 cattle and 38 water buffaloes found to be infected with Cryptosporidium oocysts using Kinyoun acid fast stain from a previous study, were subjected to loop-mediated isothermal amplification (LAMP) assay using specific primers for Cryptosporidium parvum (C. parvum) from three municipalities, Maria, Baler and San Luis of the province of Aurora in the Philippines. Results of the fecalysis using Kinyoun acid fast stain and LAMP assay were compared with the PCR results of the examined farmer/owner who raised these animals to determine the possible zoonoses of C. parvum between the farmers and their animals. Using LAMP assay, only 41% (7/17) were positive in cattle and 76% (29/38) in water buffaloes. Out of the seven LAMP positive cases in cattle, 86% (6/7) came from Maria and 14% (1/7) from Baler. Out of 29 LAMP positive cases in water buffaloes, 62% (18/29) came from Maria, 24% (7/29) from Baler and 14% (4/29) from San Luis. Comparing with the earlier results for probable zoonoses of C. parvum between the farmers and their animal was determined. Eight farmers that were positive in PCR and with their water buffaloes, positive in LAMP assay were detected to have C. parvum. Only one farmer with his cattle was detected positive of Cryptosporidium spp. in PCR, however, it was negative in LAMP assay hence, a non-parvum species might infected the farmer and the animal.

Morphological variations on microscopy in oocysts of coccidian parasites: A prospective study from a tertiary care hospital in north India.

The modified acid fast staining technique is a commonly used procedure for the detection of coccidian parasites in developing countries. The morphological variations observed in these parasites play a significant role to some extent in both identification and diagnosis of these parasitic infections. A prospective cross sectional study was performed over three years. The fecal smears were stained by modified Kinyoun acid-fast staining technique and were extensively studied for morphological variations in the coccidian parasites. Out of a total of two thousand one hundred fifty one (n = 2,151) fecal samples received during the study period, 259 samples (12%) were positive for any one of the coccidian parasites. Morphological variations, especially in the staining character was noted in all the three coccidian parasites. This study was an attempt to characterize different variations in size, shape and staining characteristics of the three coccidian parasites.

Detection of high serum levels of \u03b2-D-Glucan in disseminated nocardial infection: a case report

Backgroundβ-D-glucan (BDG) is a helpful diagnostic marker for many invasive fungal infections, but not for nocardiosis. Here, we reported the first case of nocardial infection with high serum level of BDG.Case presentationA 73-year-old man was hospitalized because of fever, headache, and appetite loss after 10 months of steroid and immunosuppressive therapy for cryptogenic organizing pneumonia. With a diagnosis of bacterial pneumonia, treatment with ampicillin/sulbactam was initiated. There was improvement on chest radiograph, but fever persisted. Further work-up revealed multiple brain abscesses on cranial magnetic resonance imaging (MRI). Serum galactomannan and BDG were elevated at 0.6 index and 94.7 pg/ml, respectively. Voriconazole was initiated for presumed aspergillus brain abscess. However, fever persisted and consciousness level deteriorated. Drainage of brain abscess was performed; based on the Gram stain and Kinyoun acid-fast stain, disseminated nocardiosis was diagnosed. Voriconazole was then shifter to trimethoprim/sulfamethoxazole. The presence of Nocardia farcinica was confirmed by the 16S rRNA gene sequence. Treatment course was continued; BDG level normalized after 1 month and cranial MRI showed almost complete improvement after 2 months.ConclusionBDG assay is widely used to diagnose invasive fungal infection; therefore, clinicians should be aware that Nocardia species may show cross-reactivity with BDG assay on serum.

Occurrence of Cryptosporidium spp. and Giardia spp. in pigs at weaning

Cryptosporidium spp. and Giardia spp. are parasites and have been reported in many species of mammals, including humans. The goal of this research was to investigate the occurrence of Cryptosporidium spp. and Giardia spp. in 45-days-old pigs. Fecal samples of 107 pigs were collected at three alternate days in piggeries in Araçatuba, São Paulo State, Brazil. Cryptosporidium oocysts were observed in 4.7% (5/107) of animals by Kinyoun acid-fast stain method and cysts of Giardia spp. were observed in 1.9% (2/107) of the animals by the method of Faust. Of all animals, 85 presented feces with normal consistency and 22 showed diarrhea in at least one collection. Two diarrheic samples showed positivity for both Cryptosporidium spp. and Giardia spp. From these results it is possible to infer that the occurrence of Cryptosporidium and Giardia was low because of the good management practices and both protozoa were not associated the presence of symptoms.

Blastocystis Species: Guilty or Innocent?

Blastocystis spp. was previously considered to be a member of normal intestinal flora; it is now receiving increased attention as a potential causative agent of human intestinal disease. The present study attempts to investigate the pathogenicity of Blastocystis spp. in clinically symptomatic patients. Eighty-six immunocompetent patients with intestinal Blastocystis spp. were evaluated clinically. Two consecutive stool samples were examined by wet mount, modified formol ethyl acetate concentration method and trichrome and Kinyoun acid-fast staining. Presence of more than 10 various morphological forms of Blastocystis spp. under 40× magnification was taken as a criterion for the presence of protozoan. Patients with other pathogens were excluded from the study. Metronidazole was administered for five to seven days. After treatment, stool sample of patients were re-examined for Blastocystis spp. There were 39 males and 47 females with a mean age of 39.8 years ± 18.8 (range 19–62 years). Abdominal pain was the most frequent symptom (77.9%) followed by diarrhea (65.1%). A second stool specimen was obtained from 61 (70.9%) patients after metronidazole therapy. Consecutive investigation revealed no intestinal protozoa in 56 (91.8%) patients. Symptoms persisted in five patients. Out of 56 patients who complained of diarrhea, 51 showed improvement in symptomology with no protozoan found. If all other pathogens and factors causing intestinal pathologies are ruled out and only Blastocystis spp. is present in symptomatic patients, it is logical to consider them as pathogenic rather than commensals and treatment can be initiated in such cases. However, further studies for genetic association and prevalence are needed to strengthen this view.

Intestinal parasitic infections in patients with Diabetes Mellitus: A case-control study

Introduction: Patients with diabetes mellitus (DM) are at increased risk of certain infections; however, little is known about the prevalence of intestinal parasitic infections in them. The aim of this study was to assess the risk of intestinal parasitic infections in patients with DM in comparison with a healthy control group. Methods: This case-control study was conducted on 118 patients with DM and 118 healthy people as control group from April to September 2014. Oral glucose tolerance test (OGTT) and hemoglobin A1c level were checked, and checklists including risk factors for parasitic infections were filed for all participants. Three stool samples and one scotch tape were obtained. Samples were examined by direct wet smear, formol-ether concentration, Kinyoun acid-fast staining, and modified trichrome stain. Data were analyzed using chi-square and logistic regression tests. Results: The rate of parasitic infection was significantly more in the patients (26.3%) than the controls (6.8%) (P < 0.050). The most detected infection was Blastocystis hominis (n = 14) followed by Endolimax nana (n = 10) and Giardia lamblia (n = 5). Infection with B. hominis was significantly more in the DM patients (9.3%) than in the controls (2.5%) (P < 0.050). DM [odds ratio (OR) = 3.6], female gender (OR = 3.0), and the presence of symptoms (OR = 9.900) were the risk factors for intestinal parasitic infections (P < 0.050).Conclusion: Patients with DM might be at an increased risk of infection with intestinal parasites specifically B. hominis as an opportunistic infection, and routine stool examination should be considered for them.

Intestinal protozoal and helminthic infections in immunocompromised patients attending RIMS Hospital, Imphal

Background: Intestinal parasites continue to be a significant health problem among immunocompromised patients in both developed and developing countries. With the increasing numbers of immunocompromised individuals throughout the world, closer examination and detection of intestinal protozoal and helminthic infections in these individuals is highly needed. Objectives: To find out the prevalence of various intestinal protozoal and helminthic infections in immunocompromised individuals and to compare the pattern of their infection depending on sociodemographic characteristics. Materials and Methods: One hundred seventy stool samples of immunocompromised patients were examined by direct wet mount, formol-ether concentration, Modified Kinyoun's acid-fast stain, and Kato-Katz technique. Data analysis was performed by using SPSS version 17 software. Results: Thirty-two intestinal parasites were detected, of which Ascaris lumbricoides was the most frequently detected parasite (5.90%) and the least frequent was Trichuris trichiura (1.18%). Twenty-one parasites were detected in the immunocompromised patients from rural areas. Conclusion: Immunocompromised patients, especially human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients from rural areas, were found to have more intestinal protozoal and helminthic infections compared to urban patients due to low socioeconomic status and poor hygiene conditions.

English

INTRODUCTION: Cryptosporidium was first reported as a human pathogen in 1976. In the 1980s it emerged worldwide as a common cause of acute, self-limiting gastroenteritis in otherwise healthy individuals especially children and of severe or life threatening infection in the severely immuno compromised patients. MATERIAL ANDMETHODS: A total of 376 Human and 100 animal faecal samples were collected and processed as per standard microbiological procedure. Oocyst of cryptosporidium was detected by modified Kinyoun acid fast staining RESULTS: Maximum cases of cryptosporidium detected in patients with symptoms out of which 7 in immuno competent and 1 in immunocompromised. In immunocompetent subjects, the symptomatic patients showed increased incidence of cryptosporidium while in immunocompromised subjects only 1 case of cryptosporidium was detected. Out of 7 detected case of cryptosporidium in immunocompetent with symptoms 4(57.1%) were males and 3(42.9%) were females. In the same category in the group without symptoms cryptosporidium was detected in 1 subject out of 75 and that too was a female (100%). In immunocompetent subjects with symptoms. CONCLUSION: In conclusion, routine screening of faecal specimens should be encouraged for detection of cryptosporidium. Water reservoirs should be prohibited for animal use since they are widely present in animal population and can cause outbreaks of cryptosporidial diarrheoa.

Clinical, serological, and parasitological analysis of snakes naturally infected with Cryptosporidium serpentis

Infection by Cryptosporidium serpentis is one of the most important diseases in reptiles and is characterized by chronic clinical or subclinical infection and the presence of hypertrophic gastritis, food regurgitation, progressive weight loss, mortality, and intermittent or continuous shedding of oocysts in the feces. The objectives of this study were to standardize an indirect enzyme-linked immunosorbent assay (ELISA) to detect antibodies against C. serpentis and to evaluate the clinical, parasitological, and humoral immune response in snakes naturally infected with C. serpentis. Twenty-one snakes naturally infected with C. serpentis and housed at the Butantan Institute, São Paulo, Brazil, underwent clinical and parasitological analyses for C. serpentis infection through daily records of clinical signs and a monthly survey of fecal shedding of oocysts using the Kinyoun's acid-fast staining. The serological evaluation was performed monthly by indirect ELISA using crude total antigen from oocysts of C. serpentis to detect anti-C. serpentis antibodies. Clinical symptoms consisted of food regurgitation, inappetence, and progressive weight loss. The parasitological analysis revealed intermittent fecal shedding of a variable number of oocysts in all snakes, with positivity in 85.32% (157/184) of the samples. The indirect ELISA was positive in 68.25% (86/126) of the samples. A humoral immune response was observed in most animals; however, fluctuating antibodies levels, leading to alternating positive and negative results, were observed in most snakes.

Investigation of Giardia and Cryptosporidium Prevalence with Different Methods in Adana Food Workers

Carriage detection in food workers is very important in protecting public health from Giardia and Cryptosporidium infections which are two of the major causes of food borne outbreaks. However, false negative results can be reported with routine methods such as native-lugol and acid-fast staining in the carriers. In this study, we aimed to determine the appropriate method for carrier screening by comparison of the different analyses used in the diagnosis of Giardia and Cryptosporidium in food workers. Stool specimens of 500 food worker who applied to our laboratory for carrier screening were investigate by routine microscopic examination with native-lugol and Kinyoun acid-fast stain method and searched for Giardia and Cryptosporidium antigens with Direct Fluorescent Antibody (DFA) and immunochromatographic assay. As a result of the study, Giardia spp. was detected with native-lugol staining method, immunochromatographic assay and DFA assay as 13 (2.6%), 8 (1.6%), 24 (4.8%) respectively of specimens whereas Cryptosporidium spp. was not determined. When DFA assay was considered the reference method, sensitivity and specificity of the native lugol method and immunochromatographic assay were found to be 54.1%, 100% and 33.3%, 100% respectively. In our study, we were found low sensitivity of immunochromatographic method and it is inappropriate as a test for detecting carriers in food workers. We concluded that, to be able to detect other parasites, the native-lugol method must be performed for screening şekilcarriers, and patients who were found Giardia and Cryptosporidium negative by this assay should be confirmed with more sensitive immunodiagnostic method.

Treatment of Microsporidial Keratoconjunctivitis With Repeated Corneal Swabbing

To report the effect of repeated corneal swabbing in patients with microsporidial keratoconjunctivitis. Retrospective noncomparative case series. Sixteen eyes of 14 healthy patients with microsporidial keratoconjunctivitis were diagnosed based on the detection of microsporidia in corneal scrapings using Gram stain, the modified Kinyoun acid-fast stain, or both. Polymerase chain reaction plus gene analysis of the microsporidian 16S ribosomal RNA had been performed in 10 patients who sought treatment between 2010 and 2011. Some of the lesions were scraped for procurement of specimens. The remaining lesions were wiped off gently by cotton swabs. Repeated swabbing was performed if infection persisted or new lesions were observed at follow-up. To prevent secondary bacterial infection, 0.3% norfloxacin or 0.25 % chloramphenicol were prescribed. The mean age was 52.2 years. All patients had the characteristic disseminated, punctate, slightly elevated, white epithelial lesions. The denser white lesions could be removed easily after gentle swabbing, and most epithelium remained intact. The 10 cases with positive polymerase chain reaction results were all identified to be Vittaforma corneae. The mean number of corneal swabbing was 3.3, and the mean disease resolution time was 6.6 days. No patients had recurrence or loss of visual acuity at last follow-up. Repeated swabbing effectively can eradicate corneal epithelial microsporidial lesions in approximately 1 week. It is easy to perform, less painful, and more acceptable for the patients.

A modified acid-fast staining method for rapid detection of Mycobacterium tuberculosis

A modified acid-fast staining method was developed for rapid detection of Mycobacterium tuberculosis and its L forms, wherein carbol fuchsin and dioxogen were mixed into the sputum smear. With this method, the dyeing time is shortened and heating is not required. The sensitivity, specificity, positive predictive value, negative predictive value, positive rate, and diagnostic efficiency of the new method were compared to those obtained by PCR using 50 clinical samples. Further, 468 clinical samples were analyzed using the new method, the modified intensified Kinyoun (IK) acid-fast staining method, and the traditional Ziehl–Neelsen acid-fast staining method. Differences among the positive detection rates of the three methods were analyzed using Student's t-test, and no significant differences were found between the new method and the modified IK acid-fast staining method, while the rates of both these methods were higher than that of the traditional acid-fast staining method. Additionally, the dyeing time in the new method was markedly less than that in the modified IK acid-fast staining method (5min and 24h, respectively).

Diyareli bir Hastada Cyclospora Ookistlerinin ve Entamoeba histolytica Adhezin Antijenlerinin Birlikteliği

Cyclospora cayetanesis is a pathogenic protozoan characterized with prolonged diarrhea in immunocompetent and immunocompromised patients. Despite its ubiqutous distribution, reports on this parasite from Turkey are scarce. Our case is a 28 years old patient, a nurse, who presented to the emergency department in June 2009 with diarrhea, nausea and vomiting during the last week. The stool specimen examination by Kinyoun's acid-fast stain revealed Cyclospora oocysts. Adhesin antigen of Entamoeba histolytica was also positive. The patient was treated with a combination of trimethoprim/sulfamethoxazole and ornidazol and she fully recovered. The literature was reviewed and our case proved to be the first report on the coexistance of Cyclospora oocysts and Entamoeba histolytica adhesin antigen in a diarrheic patient. This case underlines the importance of screening for parasites in patients with diarrhea.

Microsporidial Keratitis in Patients with Hot Springs Exposure

This retrospective study included 10 eyes of 9 patients diagnosed with microsporidial keratitis. All of them were known to contract this disease after taking baths in hot springs. The disease was diagnosed based on detecting microsporidia in corneal scrapings using Gram stain and the modified Kinyoun's acid-fast stain. The specimens from the last six patients were subjected to PCR and then sequencing. All of them revealed that the microorganism identified has a high similarity to Vittaforma corneae. Repeated debridement of the epithelial lesions successfully eradicated the microsporidial infection in all nine patients.

Nocardia elegans infection involving purulent arthritis in humans

Nocardia elegans infection in humans is rare and is predominantly associated with pulmonary infections. We describe the first case of N. elegans infection associated with purulent arthritis in humans. The patient was a 66-year-old woman without underlying disease. She had swelling in her left ankle that was increasing in size, but it did not cause the patient substantial pain. Punctual discharge was collected for Gram staining and Kinyoun's acid-fast staining. The results of microscopic findings were suggestive of the genus Nocardia. The 16S rRNA sequence of the isolate was completely identical (100%) with that of N. elegans, indicating that the isolate was N. elegans. All the previously reported 4 cases of N. elegans infection in humans were associated with respiratory infections; we present the first case of the infection involving purulent arthritis.

ImmunoCard STAT! cartridge antigen detection assay compared to microplate enzyme immunoassay and modified Kinyoun's acid-fast staining technique for detection of Cryptosporidium in fecal specimens

Cryptosporidium species infect humans and a wide range of animals worldwide; outbreaks of cryptosporidiosis have been reported in several countries. Routine diagnostic methods may be insufficient to demonstrate the presence of these organisms. The study assessed the diagnostic accuracy of the antigen detection immuno-cartridge test, ImmunoCard STAT! (Meridian Bioscience Inc., Cincinnati, OH, USA), compared to the combined gold standard: modified Kinyoun's acid-fast technique confirmed with the microplate enzyme immunoassay (EIA) for the detection of Cryptosporidium in fecal specimens. Three hundred fifteen formalin-fixed stool specimens were submitted for testing. The Kinyoun's acid-fast-stained smear revealed 24 positive samples for Cryptosporidium (of which 23 specimens were confirmed by the EIA) and 291 negative samples (of which 289 were negative by EIA). Agreement between the three used tests was shown in 22 positive and 288 negative samples for Cryptosporidium. Kappa score of agreement between the immuno-cartridge test and EIA was 0.957, p = 0.000. The sensitivity of the immuno-cartridge test was 96% (95% confidence interval (CI), 87% to 104%) and the total accuracy of the test was 97% (95% CI, 93-103). The ImmunoCard STAT! Cryptosporidium cartridge assay is easy to use and does not require specialized training or equipment and is useful in routine diagnosis and screening for Cryptosporidium especially where rapid, point of care testing is needed or where other reliable tests are unfeasible with a performance comparable to the EIA and acid-fast technique.

The Epidemiology Research of Blastocystis hominis in the Dokuz Eylül University Medical Faculty Hospital between 2005 and 2009

An investigation of Blastocystis hominis (B. hominis) prevalance in 17756 patients with gastrointestinal system complaints who presented at the parasitology laboratory of the Dokuz Eylul University Medical Faculty Hospital between January 2005 and December 2009 was carried out. Fecal samples of all patients were examined using the native-Lugol and trichrome and Kinyoun acid-fast staining method after sedimentation in fecal concentration tubes. One or more parasites were detected in 1510 (8.50%) of the patients. The distribution of the intestinal parasites was as follows: B. hominis 778 (4.38%), nonpathogenic amoebas 343 (1.93%), Giardia intestinalis (G. intestinalis) 205 (1,15%), Enterobius vermicularis (E. vermicularis) 46 (0.25%), Entamoeba histolytica/Entamoeba dispar (E. histolytica/E. dispar) 34 (0.19%), and other rare parasites 104 (0.58%). The most frequently seen parasite was B. hominis in fecal samples of patients with gastrointestinal complaints in our study. Distribution of 778 patients with B. hominis due to parasite forms was determined as: vacuolar in 525 (67.49%), granular in 115 (14.78%), both vacuolar and granular in 138 (17.73%) cases. As B. hominis was the most frequently seen parasite in patients with gastrointestinal complaints, we suggest that the parasite should be considered as pathogenic and sufficient attention must be paid in routine stool examinations.