Cryptosporidium parvum bovine genotype oocysts in the respiratory samples of an AIDS patient: efficacy of treatment with a combination of azithromycin and paromomycin.
Cryptosporidium has been recognized as an emerging zoonotic agent of intestinal cryptosporidiosis leading to diarrhea, malabsorption syndrome, and weight loss in AIDS patients. In the present case, oocysts of zoonotic Cryptosporidium parvum were detected in the sputum and stool samples of an AIDS patient with a 3-month history of intestinal cryptosporidiosis. The oocysts were detected by modified Ziehl-Neelsen staining; confirmation was achieved by nested polymerase chain reaction (PCR), targeting the most polymorphic region of the 18S rRNA gene. Genotyping was done by restriction endonuclease digestion of the PCR product. The zoonotic C. parvum bovine genotype was identified in both intestinal and respiratory samples. Treatment with both azithromycin and paromomycin resulted in improvement of both intestinal and respiratory symptoms, as well as the elimination of the parasite. This is the first report of the identification of Cryptosporidium sp. oocysts in the respiratory samples obtained from an AIDS patient in Iran. Pulmonary cryptosporidiosis should be considered whenever an AIDS patient with intestinal cryptosporidiosis develops respiratory symptoms.
Meamar
Ahmad-Reza
AR
Department of Medical Parasitology and Mycology, Division of Intestinal and Genital Protozoal Diseases, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, P.O. Box 14155, Tehran, 6446, Iran.
Rezaian
Mostafa
M
Rezaie
Sasan
S
Mohraz
Minoo
M
Kia
Eshrat B
EB
Houpt
Eric R
ER
Solaymani-Mohammadi
Shahram
S
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000469:parasitology; D000328:Adult; D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use; D003457:Cryptosporidiosis / Q000188:drug therapy* / Q000469:parasitology*; D016785:Cryptosporidium parvum / Q000145:classification / Q000302:isolation & purification*; D016172:DNA Fingerprinting; D016054:DNA, Protozoan / Q000032:analysis / Q000235:genetics; D004275:DNA, Ribosomal / Q000032:analysis / Q000235:genetics; D004359:Drug Therapy, Combination; D005243:Feces / Q000469:parasitology; D005838:Genotype; D006801:Humans; D008174:Lung Diseases, Parasitic / Q000188:drug therapy* / Q000469:parasitology; D008297:Male; D033661:Oocysts / Q000166:cytology; D010303:Paromomycin / Q000627:therapeutic use; D016133:Polymerase Chain Reaction / Q000379:methods; D012150:Polymorphism, Restriction Fragment Length; D013183:Sputum / Q000469:parasitology
D000981:Antiprotozoal Agents; D016054:DNA, Protozoan; D004275:DNA, Ribosomal; D010303:Paromomycin; D017963:Azithromycin