title: First report of Cystoisospora belli parasitemia in a patient with acquired immunodeficiency syndrome.
abstract: Cystoisospora belli in patients with the acquired immunodeficiency syndrome (AIDS) has been described as cause of chronic diarrhea and disseminated cystoisosporosis. Diagnosis of intestinal cystoisosporosis can be achieved at the tissue level in the villus epithelium of the small bowel. Disseminated cystoisosporosis is diagnosed by microscopy identification of unizoite tissue cysts in the lamina propria of the intestine. We report a case of disseminated cystoisosporosis in a human immunodeficiency virus (HIV)-infected patient with detection of parasitemia. We studied a 39-year old patient with AIDS and chronic diarrhea by analysis of stool and duodenal biopsy samples. Blood samples were also collected and examined by light microscopy and molecular techniques for C. belli DNA detection. The unizoite tissue cyst stages were present in the lamina propria, with unsporulated oocysts in feces. Zoites were present in blood smears and DNA of C. belli was detected in blood samples. Our study identified a new stage in the life cycle of C. belli. Detection of parasitemia is a novel and noninvasive tool for diagnosis of disseminated cystoisosporosis.
authors.forename: Jorge Néstor
authors.initials: JN
authors.lastname: Velásquez
authors.forename: Cecilia Alicia
authors.initials: CA
authors.lastname: di Risio
authors.forename: Cristina Beatriz
authors.initials: CB
authors.lastname: Etchart
authors.forename: Agustín Víctor
authors.initials: AV
authors.lastname: Chertcoff
authors.forename: Mónica Gabriela
authors.initials: MG
authors.lastname: Nigro
authors.forename: María Laura
authors.initials: ML
authors.lastname: Pantano
authors.forename: Bibiana Alba
authors.initials: BA
authors.lastname: Ledesma
authors.forename: Natalia
authors.initials: N
authors.lastname: Vittar
authors.forename: Silvana
authors.initials: S
authors.lastname: Carnevale
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D001706:Biopsy; D001769:Blood / Q000469:parasitology*; D003048:Coccidiosis / Q000175:diagnosis* / Q000469:parasitology / Q000473:pathology; D016054:DNA, Protozoan / Q000032:analysis / Q000097:blood; D003967:Diarrhea / Q000175:diagnosis / Q000469:parasitology / Q000473:pathology; D004386:Duodenum / Q000469:parasitology / Q000473:pathology; D005243:Feces / Q000469:parasitology; D007413:Intestinal Mucosa / Q000469:parasitology; D008853:Microscopy; D009092:Mucous Membrane / Q000469:parasitology; D018512:Parasitemia / Q000175:diagnosis* / Q000469:parasitology / Q000473:pathology; D021745:Sarcocystidae / Q000302:isolation & purification*
chemical_list: D016054:DNA, Protozoan