Symptoms Of Gastrointestinal Infection Research Articles

Chest wall abscess and costochondritis due to Salmonella enterica serotype Choleraesuis: a case report

BackgroundSalmonella enterica serotype Choleraesuis infections usually cause self-limited gastrointestinal diseases. Extra-abdominal infections are often secondary to bacteremia in immunocompromised individuals and are relatively rare in immunocompetent hosts.Case presentationA 65-year-old Caucasian female initially presented to the thoracic surgery clinic due to a poorly healing wound on her chest. Her condition started after a mechanical fall hitting her chest with interval development of a tender lump that later spontaneously drained. A chest computed tomography scan with intravenous contrast demonstrated an abnormal infiltration with small foci of fluid and air consistent with a small abscess anterior to the left seventh costal cartilage. Aspirate culture of the abscess grew S. enterica serotype Choleraesuis susceptible to ampicillin and trimethoprim/sulfamethoxazole. The patient had no prior history of signs or symptoms of gastrointestinal infection. Blood cultures were negative. With a background of penicillin allergy, she was treated with trimethoprim/sulfamethoxazole, and later with ceftriaxone due to persistent drainage of the wound. Follow-up chest computed tomography scan with intravenous (IV) contrast showed continued abnormal findings previously seen in the computed tomography scan with the appearance of a sinus tract. The patient subsequently underwent surgical debridement and partial resection of the left seventh costochondral cartilage and excision of the fistula. She had an uneventful recovery and complete resolution of her condition.ConclusionWe report a rare case of chest wall abscess with associated costochondritis due to S. enterica serotype Choleraesuis in a patient with no evidence of immunodeficiency nor history of bacteremia. Extraintestinal infections due to Salmonella without documented bacteremia have been previously reported in the literature. History of local trauma to the affected area might contribute to the seeding of infection. Diagnosis is often accomplished by clinical evaluation and culture of the affected area. Treatment often involves targeted antibiotic therapy but may require surgical intervention to achieve source control and cure.

Clinical Analysis of 17 Adult Patients With Fulminant Type 1 Diabetes Mellitus

To explore the clinical characteristics of adult patients with fulminant type 1 diabetes mellitus (FT1DM), a specific subtype of type 1 diabetes mellitus (T1DM). We collected the clinical data of patients who were admitted to West China Hospital, Sichuan University in 2010-2019 for FT1DM and type 1 diabetes mellitus (T1DM) presenting with diabetic ketoacidosis (DKA) at the onset. In addition, all the FT1DM patients were followed up. A total of 70 patients presenting with DKA at the onset of T1DM were admitted to and received treatment at West China Hospital in 2010-2019. Among them, 17 (24.3%) had FT1DM and 53 did not. The mean ages of the FT1DM patients and the non-FT1DM patients were (33.2±12.8) years and (27.5±11.2) years, and the mean body mass indices were (22.6±2.9) kg/m 2 and (19.2±2.9) kg/m 2, respectively. A total of 14 FT1DM cases had symptoms of upper respiratory tract infection or acute gastroenteritis before the onset of the disease and 4 cases were related to pregnancy. The median time from the onset of the disease to the first diagnosis of DKA of the FT1DM group (median [P 25-P 75]: 2 [1-4] days, P<0.001) was significantly shorter than that of the non-FT1DM group (median [P 25-P 75]: 30 [17-78] days). The mean maximum blood glucose levels at the time of the first visit to the doctor of the FT1DM patients ([39.9±11.4] mmol/L, P<0.001) were significantly higher than that of the non-FT1DM patients ([28.9±9.2] mmol/L), but the HbA1c (6.6%±0.6%, P<0.001) and glycosylated serum albumin (GA) (21.4%±3.0%, P=0.001) levels of the FT1DM patients were significantly lower than those of the non-FT1DM group (HbA1c: 12.8%±2.7%; GA: 44.8%±15.0%). The median serum amylase in the FT1DM group was significantly higher than that in the non-FT1DM group (101 [54-336] IU/L vs. 54 [42-166] IU/L, P=0.045) and the median serum lipase in the FT1DM group showed a trend of being higher than that in the T1DM group (81 [57-154] IU/L vs. 46 [28-195] IU/L, P=0.051). 8.7% of the non-FT1DM patients tested positive for anti-glutamic acid decarboxylase antibody (GAD-Ab), while the FT1DM patients all tested negative. At the time of discharge, the mean daily insulin dose of the FT1DM patients was (0.67±0.22) IU/kg, which was not significantly different from that of the non-FT1DM group ([0.74±0.29] IU/kg, P=0.349). After about 6.5 years of follow-up, the mean daily insulin dose of the FT1DM patients was (0.73±0.19) IU/kg, which was similar to the insulin dosage on discharge ( P=0.409). Compared with the non-FT1DM patients presenting with DKA at the onset, FT1DM patients have fewer typical diabetic symptoms, lower fasting C-peptide levels, higher serum amylase levels, and increased incidence of vomiting or other symptoms of gastrointestinal infections, and are more likely to be misdiagnosed. Therefore, it is very important for clinicians to correctly identify FT1DM as early as possible and administer early and long-term insulin replacement therapy.

Incidence and Socioeconomic Impact of Intestinal Parasitic Infections among School Going Children of Private and Public Sectors Schools

Background: Parasitic infection is one of the most common infections in school age children because of poor quality of water, deprived sanitation system and lack of enough health care facilities in underdeveloped countries. Parasitic infections lead to anemia, growth retardation, weight loss, and other physical and mental health problems in children. Current study is designed to evaluate frequency of different intestinal parasitic infections and possible associated risk factors among school students in of District Buner Pakistan. Material and method: This Descriptive cross-sectional study was conducted at Riaz Clinical Laboratory District Buner. All asymptomatic school going children between 5 to 15 years’ age of both genders were included in the study. Those students who had present with symptoms of gastrointestinal infection were excluded from the study. A total of 440 samples were collected from different public and private school’s children. Out of total 240 samples were collected from public sector schools and 200 samples from private sector school’s children. A pretested structured questionnaire was used to gather data on socio-demographic and associated risk factors. The adequate stool specimens were collected in sterile, screw caped disposable plastic container. All samples were examined under microscope using a direct wet mount and formal ether concentration technique. Data was analyzed through SPSS-22 and presented in the form of tables, Pie chart and bar graphs. Results: Out of 440 samples, 23.63% (104/440) were positive for an ova and cysts of different parasites. The parasite positivity ratio is greater in public sector school children (30%) compare to private sector school children (16%). Taenia saginata were most common parasite (8.4%) in school age children followed by Hymenolepis nana (5.68%), Ascaris lumbricoides (5.45%), Enterobius vermicularis 1.13%, and Strongyloides stecoralis (0.68%) were least common parasite in District Buner, Khyber Pukhtoonkhwa. Conclusion: Major contributor for the high prevalence of parasitic infections in public school children were found to be poor personal and environmental hygiene, lack of proper sanitation, contaminated food and water supply, personal habits of the children like nail biting and finger sucking, illiterate mother and low socio-economic status of the individuals. Keywords: Intestinal parasites, Worm infestation, School going children, Socioeconomic impact

Mapping of etiologies of computed tomography-proven acute colitis: a prospective cohort study

Our objective was to describe the etiologies of acute colitis and to identify patients who require diagnostic endoscopy. Patients with symptoms of gastrointestinal infection and colonic inflammation on CT were prospectively included. Those immunosuppressed, with history of colorectal cancer or inflammatory bowel disease (IBD), were excluded. Microbiological analysis of the feces was performed using PCR assays BD-Max and FilmArray (GI panel,) and fecal cultures. Fecal calprotectin was determined. Patients with negative BD-Max underwent colonoscopy. One hundred and seventy-nine patients were included. BD-Max was positive in 93 patients (52%) and FilmArray in 108 patients (60.3%). Patients with infectious colitis (n = 103, 57.5%) were positive for Campylobacter spp. (n = 57, 55.3%), Escherichia coli spp. (n = 8, 7.8%), Clostridioides difficile (n = 23, 22.3%), Salmonella spp. (n = 9, 8.7%), viruses (n = 7, 6.8%), Shigella spp. (n = 6, 5.8%), Entamoeba histolytica (n = 2, 1.9%) and others (n = 4, 3.9%). Eighty-six patients underwent colonoscopy, which was compatible with ischemic colitis in 18 patients (10.1%) and IBD in 4 patients (2.2%). Fecal calprotectin was elevated in all patients, with a mean concentration of 1922.1 ± 2895.6 μg/g, and was the highest in patients with IBD (8511 ± 9438 μg/g, p < 0.001). After exclusion of patients with infectious etiology, a fecal calprotectin > 625 μg/g allowed identifying patients with IBD with an area under ROC curve of 85.1%. To conclude, computed tomography-proven colitis was of infectious etiology in 57.5% of patients. The main pathogens identified were Campylobacter spp. (55.3%), Clostridioides difficile (22.3%) and Salmonella spp. (8.7%). Ischemic colitis (10.1%) and IBD (2.2%) were seldom represented. No colorectal cancer was found.

Гастроінтестинальні симптоми при гострих нейроінфекціях у дітей

Актуальність. При тяжких формах інфекційних захворювань окрім локального запалення можуть відбуватися вторинні ураження органів шлунково-кишкового тракту (ШКТ). Мета дослідження. Вивчити семіотику та епідеміологію гастроінтестинальних симптомів у дітей з гострими нейроінфекціями. Матеріали та методи. Дослідження обсерваційне ретроспективне, типу «випадок — контроль». Був проведений аналіз історій хвороби дітей віком від 1 місяця до 18 років, які проходили стаціонарне лікування з приводу гострих нейроінфекцій (менінгіт, енцефаліт та енцефаломієлополінейропатія). Результати. Дослідження включало 117 дітей з гострими інфекційними ураженнями нервової системи. Клінічні симптоми ураження ШКТ спостерігались у 83 (70,9 %) дітей. У симптоматиці переважали порушення моторики кишечника (запор і діарея). Прояви ураження гепатобіліарної системи у вигляді підвищення трансаміназ (аланінамінотрансферази (АЛТ), лужної фосфатази (ЛФ), гамма-глутамілтранспептидази (ГГТП)) та/або змін при ультразвуковому дослідженні (збільшення розмірів, дифузні структурні зміни) спостерігались у 39,1 % хворих. Серед лабораторних показників підвищені рівні АЛТ у 8,3 % пацієнтів, білірубін підвищений тільки в однієї дитини, ЛФ вище вікової норми у 11,8 %, підвищення ГГТП від вікової норми — у 31,3 % хворих. Рівень біомаркеру I-FABP був підвищений у 86,4 % хворих, L-FABP — у всіх (100 %) пацієнтів. Клінічні прояви гастроінтестинальної дисфункції (наявність принаймні одного з гастроінтестинальних симптомів) мали обернений зв’язок з віком дитини (точково-бісеріальний коефіцієнт кореляції (rpb) = –0,19; p = 0,033), корелювали з перебуванням у відділенні анестезіології та інтенсивної терапії (відношення шансів (ВШ) = +5,25; 95% довірчий інтервал (ДІ) 1,62–16,97), проведенням штучної вентиляції (ВШ = +4,5; 95% ДІ 1,00–21,69), рівнем I-FABP (rpb = 0,34; p = 0,019). Висновки. Серед гастроінтестинальних симптомів при гострих нейроінфекціях у дітей найчастіше зустрічаються порушення моторики кишечника у вигляді запору та діареї. Ураження гепатобіліарної системи переважно проявляються помірними змінами лабораторних показників. Біомаркери I-FABP та L-FABP є високочутливими тестами для діагностики ураження ШКТ і гепатобіліарної системи.

Mapping of aetiologies and clinical presentation of acute colitis: Results from a prospective cohort study in a tertiary centre

Abstract Objective Our objective was to describe the aetiologies of acute colitis and to identify patients who require diagnostic endoscopy. Methods Patients with symptoms of gastrointestinal infection and colonic inflammation on computed tomography were prospectively included. Those immunosuppressed, with history of colorectal cancer or inflammatory bowel disease (IBD) were excluded. Stools were screened with BD-Max and BioFire FilmArray GI panel. Faecal calprotectin was determined. Patients with negative BD-Max underwent colonoscopy. The study was registered into clinicaltrials.gov (NCT02709213). Results One hundred and seventy-nine patients were included. BD-Max was positive in 93 patients (52%) and FilmArray in 108 patients (60.3%). Patients with infectious colitis (n = 103, 57.5%) were positive for Campylobacter spp (n = 57, 55.3%), Escherichia coli spp (n = 8, 7.8%), Clostridium difficile (n = 23, 22.3%), Salmonella spp (n = 9, 8.7%), viruses (n = 7, 6.8%), Shigella spp (n = 6, 5.8%), Entamoeba histolytica (n = 2, 1.9%) and others (n = 4, 3.9%). Eighty-six patients underwent colonoscopy, which was compatible with ischemic colitis in 18 patients (10.1%) and IBD in 4 patients (2.2%). Among patients with negative FilmArray, a faecal calprotectin &amp;gt;625μg/g allowed identifying patients with IBD with an area under ROC curve of 85.1%. Introduction of a diagnostic management algorithm including FilmArray and faecal calprotectin could allow decreasing unnecessary colonoscopies from 82 to 29 (corresponding to a decrease of 64.6%). Conclusion Computed tomography-proven colitis was mostly of infectious aetiology. Diagnostic management of patients with acute colitis should include broad molecular testing of the stools and, in patients with a calprotectin concentration &amp;gt;625μg/g, colonoscopy to exclude IBD.

Evaluation of cochlear functions in infants exposed to SARS-CoV-2 intrauterine

PurposeThe novel coronavirus (SARS-CoV-2) caused an acute respiratory illness named COVID-19 and the disease spread all over the World. Fever, cough, fatigue, gastrointestinal infection symptoms form the main clinical symptoms. Pregnants and newborns form a vulnerable population and urgent measures must be addressed. Studies about the effect of COVID-19 on pregnant women, developing fetuses, and infants are limited. Various viral diseases can cause congenital or acquired, unilateral or bilateral hearing loss. Methods37 infants whose mother was pregnant between March 2020 and December 2020 and were born after the diagnosis of COVID- 19 during pregnancy and 36 healthy infants were included in the study. Transient evoked otoacoustic emission (TEOAE), distortion product otoacoustic emission (DPOAE) and contralateral suppression of OAE (CLS OAE) tests were performed on all infants. ResultsAccording to the TEOAE results of patients and controls in the silent a statistically significant difference was observed between the two groups at 3 kHz and 4 kHz (p < 0.05). Contralateral suppression of OAE test results of patients and controls a statistically significant difference was found in all frequencies (p< 0.05). Suppression was much more effective at all frequencies in the normal group than patient group. This difference was found to be more significant at higher frequencies (2,3 and 4 kHz) (p < 0.001). ConclusionsOur results suggest an insufficiency in medial olivocochlear efferent system in infants exposed to SARS-CoV-2 intrauterine. Cochlear functions should be examined in infants whose mothers had COVID-19.

Arbaeen public health concerns: A pilot cross-sectional survey.

Arbaeen is an annual religious procession in Iraq with an estimated 17-20 million participants. Public health risks associated with such a mass gathering can be serious at both local and global levels. This is the first quantitative examination of risk factors for, and symptoms of, infectious disease among Arbaeen participants. A cross-sectional survey was conducted of a convenience sample of 191 Arbaeen participants in 2017. Interviewers administered a structured questionnaire. Questions included food sources, preventive measures used and symptoms of infectious diseases during the procession. Data were collected for 191 participants (143 males, 58 females). The most prevalent symptoms were respiratory (runny nose: 22.6%, cough: 22.5%). Diarrhoea was reported by 12.6% of participants, with a strong association with high-income country origin and eating (commercial) street food (odds ratios 6.1 and 4.1, respectively, p<0.05). All symptoms investigated, except breathlessness, were more prevalent in high-income country participants (p<0.05). Street food and high-income country origin were independent risk factors for respiratory or gastrointestinal infection symptoms in this sample of Arbaeen participants. However, these results cannot be generalised due to possible selection bias. Further studies are required to inform policy development and health system preparedness to reduce Arbaeen-associated health risks.

The dietary inflammatory index is associated with gastrointestinal infection symptoms in the national health and nutrition examination survey

Inflammation influences many aspects of health including gastrointestinal illnesses. Associations between the Dietary Inflammatory Index (DII®) and gastrointestinal symptoms were examined using cross-sectional data from the National Health and Nutrition Examination Survey (years 2005–2014, n = 25,553). Outcomes included self-reported presence of mucus or liquid in bowel leakage and stomach illness in the past month, diarrhoea in the past year and number of weekly bowel movements. Energy-adjusted DII (E-DII) scores were estimated from one 24-h dietary recall. Analyses included survey design-appropriate logistic and linear regression. Compared to E-DII quartile 1 (anti-inflammatory), E-DII quartile 4 (pro-inflammatory) had elevated odds of mucus in leakage: 71% (95% confidence interval [95%CI] = 1.01–1.20); liquid in leakage: 74% (95%CI = 1.30–2.33); stomach illness: 43% (95%CI = 1.18–1.72); and diarrhoea: 65% (95%CI = 1.21–2.26). Those with more anti-inflammatory diets had more bowel movements. Future questions should address whether anti-inflammatory diets provide protective effects against gastrointestinal infections and if these relationships are modified by other health behaviours.

Kinetics of serum antibodies in response to infection with Yersinia enterocolitica.

Information on the kinetics of the serum antibody response to infection with Yersinia enterocolitica is essential to allow the estimation and comparison of seroconversion rates in a diversity of pools of cross-sectional serum antibody measurements. Data from 94 patients with acute enteritis caused by Yersinia infection were used. The follow-up period for the longitudinal study was 36 months, addressed by questionnaire. An indirect enzyme-linked immunosorbent assay method was adapted to determine the concentration of antibodies against Y. enterocolitica in human sera. A mathematical within-host model was used to describe the interaction between pathogen and immune system and the waning of immunity after clearing of the pathogen. All observed antibodies (IgG, IgM, IgA) reached peak levels shortly after infection and then decayed slowly indicating that the median levels decreased only little during the observation period. Estimated maximum peak antibody levels were highest in IgG. Seroresponse curves of all antibodies showed large individual variation between patients. There was no apparent pattern of variation with age, nor any notable difference between genders. Estimated half-times were very long for all antibodies, and their posterior distributions were highly skewed. IgA appeared to have the most persistent antibody response, compared with IgG and IgM. Median peak levels of all three antibodies were similar. There was no significance found between peak antibody levels and severity of symptoms of gastrointestinal infection and severity of joint pain. Our findings allow the use of cross-sectional serum antibody measurements as biomarkers, to estimate seroconversion rates. Such seroincidence estimates include asymptomatic seroconversions, thereby avoiding under-reporting, and allows the comparison of infection pressures among countries, independent of their healthcare and surveillance systems.

Preparation and Evaluation of Combined Detection of Norovirus GI and GII: An Innovative Fluorescent Particles Test Strip.

This study was designed to prepare and evaluate the sensitivity and specificity of a Norovirus GI and GII fluorescent particles combined detection test strip method. Using selected chromatographic materials and antibodies specific to Norovirus GI and GII, the Norovirus GI and GII fluorescent particles combined detection test strip (tested method) was prepared as a conventional double antibody sandwich. The samples assayed included cultured rotavirus and 465 specimens from patients with symptoms of gastrointestinal infection. Norovirus was detected using the tested method and a reference method (CerTest Norovirus GI-GII test card). The results indicated that the sensitivity of the tested method was 4 (for GI detection) or 8 times (for GII detection) greater than the reference method. Neither of the two methods cross-reacted with rotavirus and so on. For specimens, 29 were found to be negative by the reference method and positive by the tested method, and 8 were found to be negative by the tested method and positive by the reference method. Furthermore, a retesting of these samples by qPCR showed that 28 of the 29 were positive, and 3 of the 8 were positive. In summary, the Norovirus GI and GII fluorescent particles combined detection test strip was successfully prepared and had good detection performance.

Gastroenteritis in Japanese Females Caused by Shigella flexneri without Definite Infection Route: A Case Report and Mini-Review of Literature

In Japan, the incidence of Shigellosis is low at approximately 150 cases per year, with the majority of these being imported, mainly from Asia. Sporadic domestic occurrences are also reported, the majority of which absent epidemiological association. We report a case of gastroenteritis caused by Shigella flexneri in a 60-year-old Japanese female who recovered fully following treatment with levofloxacin. While we were unable to identify the route of infection, we suspected imported frozen marine products that may have been handled or processed in an unsafe manner. Shigellosis should be included in the differential diagnosis when presented with a patient exhibiting symptoms of gastrointestinal infection, even in the absence of a history of travel to an endemic area.

Sweet Syndrome in Infancy

Sweet syndrome, or acute febrile neutrophilic dermatosis, is characterized by the presence of fever, peripheral leukocytosis, painful erythematous plaques and nodules, and a predominately neutrophilic dermal infiltrate. We report a case occurring in a 10-week-old male child, with preceding upper respiratory tract, and gastrointestinal infection symptoms. Sweet syndrome occurring in an infant should prompt a work-up for immunodeficiency, as well as a review of the peripheral blood smear to rule out the rare case of malignancy.

Predominant Breast-Feeding from Birth to Six Months Is Associated with Fewer Gastrointestinal Infections and Increased Risk for Iron Deficiency among Infants1,

Iron deficiency (ID) is prevalent among infants world-wide and may be more likely among infants born to women living in disadvantaged environments. A strategy to address ID in this context is to feed iron-fortified formula, but this may create risk for gastrointestinal (GI) infection. Our objective was to investigate the relationship between infant feeding practices, iron status, and likelihood of a GI infection in the first 6 mo of life. We conducted a prospective study at a public hospital in Guadalajara, Mexico. Healthy women who gave birth to a healthy term infant were eligible to participate. Each month, mothers (n = 154) provided information on infant feeding methods and symptoms of GI infection. At 6 mo of age, infants’ iron status was assessed [hemoglobin (Hb) and serum ferritin concentration]. When compared with nonpredominantly breast-fed [partially breast-feeding (PBF) and formula feeding (FF) combined], predominantly breast-fed (PRBF) infants to 6 mo had a lower incidence of GI infection from 0–6 mo [18 vs. 33%; P = 0.04; adjusted odds ratio (OR) = 0.4; 95% CI = 0.2, 1.0] but a higher risk for ID (serum ferritin < 12 μg/L) at 6 mo (22 vs. 4%; P = 0.001; adjusted OR = 9.2; 95% CI = 2.3, 37.0). Anemia (Hb < 110 g/L) prevalence did not differ among feeding groups (13% for PRBF, 19% for PBF, and 4% for FF; P = 0.09). In this low-income population, our results suggest that PRBF should be promoted and the risk for ID managed using public health and nutrition strategies.

Prolonged dysphagia due to Listeria-rhombencephalitis with brainstem abscess and acute polyradiculoneuritis

We report a case of previously healthy student with acute rhombencephalitis and brainstem abscess caused by Listeria monocytogenes. The disease begun with uncharacteristic prodromal symptoms of gastrointestinal infection followed by headache and vertigo. After hospital admission the patient rapidly deteriorated, presenting pronounced dysphagia and respiratory failure requiring mechanical ventilation. The diagnosis was established upon clinical symptoms of infection, brainstem involvement, typical MRI findings and positive for L. monocytogenes blood culture. Infection was complicated by acute, demyelinating neuropathy, diagnosed upon clinical symptoms of frail palsy confirmed by ENG. Initially introduced empirical doxycyclin/ceftriaxon treatment was subsequently changed to targeted ampicillin/gentamycin therapy, mechanical ventilation, intravenous human immunoglobulin treatment, tracheostomy and endoscopic gastrostomy. Prolonged dysphagia resolved after rehabilitation. After one year the patient remains well with only slight dysmetria.

A prospective study of acute idiopathic neuropathy. II. Antecedent events.

The incidence of antecedent events and serological evidence of preceding infection were studied in 100 patients with acute idiopathic neuropathy and age and sex matched control subjects in South-East England. Symptoms of respiratory infections occurred within one month before onset of neuropathic symptoms in 38% of patients and 12% of controls (p less than 0.001) and symptoms of gastrointestinal infections in 17% of patients and 3% of controls (p less than 0.005). Immunisations, insect bites and animal contact were equally common in the patient and control subjects. Eight per cent of patients had undergone an operation within the preceding 3 months. Six per cent of patients had co-existing "autoimmune" diseases. Serological evidence of recent infection was identified in 31% of patients. Campylobacter jejuni (14%) and cytomegalovirus (11%) were both significantly more frequently demonstrated in patients than controls. Serological evidence of recent infection with mycoplasma (1%), Epstein Barr virus (1-2%) and parvovirus B19 (4%) was also identified in the patients but not more frequently than in the controls. Possible explanations for the association of these agents with acute idiopathic neuropathy include possession of antigens shared with myelin and inhibition of suppressor mechanisms.

CRYPTOSPORIDIUM: A FREQUENT FINDING IN PATIENTS WITH GASTROINTESTINAL SYMPTOMS

1422 faecal samples sent by general practitioners for routine parasitological examination were surveyed in 3 months. Of the 10·8% short-listed for special examination for cryptosporidium oocysts, 14 (9·1%) were positive. Charcot-Leyden crystals were not associated with cryptosporidiosis. All 14 patients had symptoms of gastrointestinal infection, which seemed to be related to a trip abroad. The incubation period varied between 4 and 12 days. Clinically cryptosporidiosis could not be distinguished from giardiasis, but its duration was shorter (median 10 days), strong abdominal pain and cramps were commoner, and bloating, anorexia, and weakness were less common. The disease can be diagnosed by identification of oocysts in faecal samples that have undergone formalin-ether concentration. There is no specific treatment for it, and recovery is spontaneous.