title: High frequency of parasitic and viral stool pathogens in patients with active ulcerative colitis: report from a tropical country.
abstract: OBJECTIVE
  Diarrhoeal relapses in patients with ulcerative colitis (UC) may be associated with enteric infections and its diagnosis may lessen avoidable exposure to corticosteroids and/or immunosuppressants. The purpose of this study was to assess the frequency of stool pathogens (parasitic and viral) in patients with active UC.
  
  
  METHODS
  This prospective cross-sectional study included 49 consecutive patients (32 M, 17 F, mean age 35.8+/-12 years) with active UC. Three stool samples were collected from each patient and examined for parasitic infection. Rectal biopsies were obtained during sigmoidoscopy to demonstrate cytomegalovirus (CMV) inclusion bodies and to conduct qualitative polymerase chain reaction (PCR) for CMV and herpes simplex virus (HSV) DNA detection.
  
  
  RESULTS
  Median duration of illness was 3.9+/-3.7 years and 83.7% of the patients had moderate to severe disease. The prevalence of parasitic infections in UC was 12%. The organisms isolated were Strongyloides stercoralis in 4%, Ankylostoma duodenale in 4%, Cryptosporidium in 2% and Entamoeba histolytica in 2% of the patients. The prevalence of CMV and HSV in rectal biopsies using qualitative PCR was 8% and 10%, respectively. No predictive factor was identified with CMV superinfection in patients with active UC.
  
  
  CONCLUSIONS
  In India there is a high prevalence of parasitic and viral infections in patients with active UC. The results of the study suggest that, in tropical countries with a known high prevalence of parasitic diseases, aggressive evaluation for parasitic and viral infections should be carried out, as early identification and prompt treatment of such infections can improve the clinical course of patients with active UC.
authors.affiliation: Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Banerjee
authors.forename: Rachana
authors.initials: R
authors.lastname: Deb
authors.forename: Lalit
authors.initials: L
authors.lastname: Dar
authors.forename: Bijay R
authors.initials: BR
authors.lastname: Mirdha
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Pati
authors.forename: Sandeep
authors.initials: S
authors.lastname: Thareja
authors.forename: Sushil
authors.initials: S
authors.lastname: Falodia
authors.forename: Vineet
authors.initials: V
authors.lastname: Ahuja
mesh_terms: D003093:Colitis, Ulcerative / Q000469:parasitology* / Q000821:virology*; D003430:Cross-Sectional Studies; D003586:Cytomegalovirus Infections / Q000453:epidemiology*; D005243:Feces / Q000821:virology; D006801:Humans; D007194:India / Q000453:epidemiology; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011446:Prospective Studies