Isosporiasis A07.3

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Isosporidiosis

History
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Virchow, 1860; Woodcock, 1915

Definition
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Atypical diarrhoea caused by a protozoan infection (especially Isospora belli). The chronic isosporidiosis with diarrhea of more than 4 weeks is AIDS-defining.

Pathogen
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Isospora belli (see protozoa below); ubiquitously occurring intestinal parasite. Globally occurring protozoon that can cause mild diarrhoea in immunocompetent individuals and severe clinical symptoms in HIV-infected individuals. Rare in Europe, a major problem in developing countries (especially in the tropics and subtropics).

Occurrence/Epidemiology
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Occurrence in 0.2% of HIV infected persons.

Clinical features
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Similar to cryptosporidiosis, the germ occasionally leads to epidemic-like outbreaks in immunocompetent individuals. Mild enteritis-like symptoms, occasionally also very strong, watery diarrhoea, abdominal pain, cramps and nausea. Often eosinophilia. In immunodeficient patients, chronic diarrhoea and finally malnutrition may occur. A chronic isosporiasis with diarrhoea of more than four weeks is AIDS-defining.

Diagnosis
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The detection of the relatively large oocysts is possible in normal stool tests for parasites, but also in acid-proof staining.

Therapy
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Cotrimoxazole (sulfamethoxazole and trimethoprim): 2 times/day 2 tbl (80 mg TMP + 400 mg SM) p.o. over 1 week. Alternatively: Ciprofloxacin 2 times/day 500 mg p.o.

Note(s)
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Sample material: Stool sample (walnut-sized) in SAF medium or stool transport tubes.

Literature
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  1. Goodgame RW (1996) Understanding intestinal spore-forming protozoa: cryptosporidia, microsporidia, isospora, and cyclospora. Ann Internal Med124: 429-431
  2. Verdier RI (2000) Trimethoprimsulfamethoxazole compared with ciprofloxacin for treatment and prophylaxis of Isospora belli and Cyclospora cayetanensis infection in HIV-infected patients. A randomized, controlled trial. Ann Intern Med 132: 885-888
  3. Woodcock HM (1915) Notes on the protozoan parasites in the excreta. Br Med J ii:704

Incoming links (2)

Coccidiosis; Protozoa;

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020