1/6. Rapid increase of mucosal CD4 T cells followed by clearance of intestinal cryptosporidiosis in an AIDS patient receiving highly active antiretroviral therapy.Highly active antiretroviral therapy (HAART) suppresses the replication of human immunodeficiency virus (HIV) and leads to an increase in circulating CD4 T lymphocytes, but its effects on other immune compartments such as the intestinal mucosa are not well understood. We describe a severely immunodeficient HIV-infected patient with intractable watery diarrhea and weight loss caused by infection with cryptosporidium parvum in whom we studied virologic and immunologic changes in both peripheral blood and the intestinal mucosa after initiating HAART. Mucosal biopsies were performed by rectoscopy before and at several time points after HAART was begun. nucleic acids were extracted from rectal biopsy specimens and blood samples, and HIV rna was measured by reverse-transcription polymerase chain reaction. lymphocytes were isolated from rectal biopsy specimens after mechanical disaggregation, and circulating and mucosal CD4 T cells were determined by flow cytometry. HAART led to clinical recovery and eradication of cryptosporidiosis. In both blood and mucosa, HIV rna decreased below the limit of detection and CD4 T cells increased. Mucosal CD4 T cells increased much faster and to much higher levels than circulating CD4 T cells. Our findings show a rapid repopulation of the intestinal mucosa with CD4 T cells after initiation of HAART that can effectively restore mucosal immunity, leading to eradication of opportunistic pathogens.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
2/6. X-linked hyper-IgM syndrome associated with cryptosporidium parvum and cryptococcus neoformans infections: the first case with molecular diagnosis in korea.X-linked hyper-IgM syndrome (XHIM) is a rare primary immunodeficiency disorder, caused by mutations of the gene encoding cd40 ligand (CD40L; CD154). We report the clinical manifestations and mutational analysis of the CD40L gene observed in a male patient from a XHIM family. Having hypogammaglobulinemia and elevated IgM, the 3-yr-old boy exhibited the characteristic clinical features of XHIM. The patient suffered from frequent respiratory infections, and chronic enteritis caused by cryptosporidium parvum. In addition, a lymph node biopsy and a culture from this sample revealed C. neoformans infection. Activated lymphocytes from the patient failed to express CD40L on their surface as assessed by flow cytometry and a missence mutation (W140R) was found at the XHIM hotspot in his CD40L cDNA to confirm the diagnosis. Genetic analysis of the mother and sister showed a heterozygote pattern, indicating carrier status. To our knowledge, this is the first report on the molecular diagnosis of an XHIM patient in korea.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
3/6. Intestinal cryptosporidiosis as an initial manifestation in a previously healthy Japanese patient with AIDS.BACKGROUND: cryptosporidium parvum infection has been recognized as one of the pathogens causing severe and persistent diarrhea in immunodeficient patients, such as those with AIDS, worldwide. However, in japan, the frequency of this infection has been rare, except for environmental contamination through the water supply. In this communication, we describe a Japanese patient with AIDS presenting with intestinal cryptosporidiosis as an initial manifestation. methods: The oocysts of cryptosporidium parvum in his stool were detected by the Ziehl-Neelsen method and electron microscopy. The antigen-specificity was proved by immunostaining, using a fluorescein isothiocyanate (FITC)-labeled monoclonal antibody and enzyme-linked immunosorbent assay (ELISA), using Cryptosporidium-specific antibody. RESULTS: A 28-year-old Japanese homosexual man was admitted to our hospital because of severe watery diarrhea of 1-week duration. Numerous oocysts of cryptosporidium parvum were observed in his stool. cryptosporidium parvum antigen was detected in stool samples. Serological examinations revealed that anti-hiv-1 antibody was positive, and HIV rna was positive at a high level. He was diagnosed as having AIDS associated with intestinal cryptosporidiosis. The circulating CD4 T-cell count was 152/microl. His diarrhea was not alleviated by administration of loperamide and an ordinary antibiotic agent, but ultimately resolved by the administration of the macrolide antibiotic agent, clarithromycin. CONCLUSIONS: We emphasize that the presence of cryptosporidium parvum infection should be kept in mind in searching for pathogens causative of severe diarrhea in AIDS patients.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
4/6. Reactive arthritis associated with prolonged cryptosporidial infection.In contrast to arthritic disease caused by different bacterial agents, reactive arthritis due to parasitic infection is rare. We report on an 8-year-old immunocompetent boy with a symptomatic intestinal cryptosporidiosis over a 13-months period. The protozoan infestation was accompanied by arthritic symptoms involving several joints at different times (migratory arthritis). Symptoms resolved spontaneously after 20 months in parallel with stool samples negative for cryptosporidia.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
5/6. Intestinal microsporidiosis in AIDS patients with diarrhoeal illness in Apulia (south italy)microsporidia are intracellular parasitic protozoa very common in immunocompromised patients in many parts of the world. There is a scarcity of data on the prevalence of these parasites in italy. In this study we examined stool samples of 56 HIV patients with diarrhoea to find microsporidial spores, using the light microscopy Ryan modified trichrome stain. microsporidia were found in one out of 56 patients, who was Cryptosporidium coinfected. Intestinal microsporidiosis seems to be less frequent in AIDS patients from italy than in those from other countries.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
6/6. Study of cryptosporidiosis in a rural area of Maharashtra.Human cryptosporidiosis has been reported world wide, both from developed and developing countries and from urban and rural areas. Present study is undertaken to assess the occurrence of cryptosporidiosis in human and cattle population (cows and calves) in and around the rural areas of Loni, district Ahmednagar, Maharashtra State. Human stool samples were collected from 220 patients of age ranging between newborn to 85 years, attending the Pravara Rural Hospital, Loni. The samples were examined using modified Ziehl-Neelsen staining technique. Drug samples were also examined from 101 asymptomatic (apparently healthy and non-diarrhoeic) cows and calves from the same area, to detect Cryptosporidium. Three positive cases (1.36%) in human and 11 positive cases (10.89%) in cattle (cows and calves) were detected. It is assumed that in rural areas the most likely source of human infection is cattle. This is the first report of human infection by Cryptosporidium from rural Maharashtra and also the first report of occurrence in cattle from india.- - - - - - - - - - ranking = 3keywords = sample (Clic here for more details about this article) |