Chronic cystoisosporiasis in an immunocompetent adult: A case report.
Administration, Intravenous
Administration, Oral
Antiprotozoal Agents
/ administration & dosage
Capsule Endoscopy
Chronic Disease
Diarrhea
/ parasitology
Humans
Immunocompetence
Intestinal Diseases, Parasitic
/ diagnosis
Isosporiasis
/ diagnosis
Male
Middle Aged
Recurrence
Trimethoprim, Sulfamethoxazole Drug Combination
/ administration & dosage
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
12 Mar 2021
12 Mar 2021
Historique:
received:
28
11
2020
accepted:
04
02
2021
entrez:
17
3
2021
pubmed:
18
3
2021
medline:
26
3
2021
Statut:
ppublish
Résumé
Cystoisosporiasis is an intestinal infectious disease caused by a coccidian protozoa, Cystoisospora belli (C. belli). It can cause prolonged and refractory diarrhea most commonly in immunocompromised patients, while immunocompetent individuals usually exhibit no symptoms or self-limited diarrhea. We herein report a case of chronic cystoisosporiasis in an immunocompetent patient. A 62-year-old man, who had been first diagnosed with cystoisosporiasis 15 years ago and had been treated with oral administration of trimethoprim-sulfamethoxazole (TMP-SMX), complained of persistent watery diarrhea. He was negative for anti-human immunodeficiency virus antibody and anti-human T-cell leukemia virus type 1 (HTLV-1) antibody. Biopsy specimens from the duodenum revealed oocysts in the atrophic absorptive epithelium and protozoa were detected through stool examination, indicating the recurrence of cystoisosporiasis. Capsule endoscopy showed diffuse atrophic mucosa with white villi in the entire small intestine. We diagnosed him with chronic cystoisosporiasis that occurred in an immunocompetent adult. Since oral administration of TMP-SMX and ciprofloxacin were ineffective, the intravenous administration of TMP-SMX was initiated. Intravenous TMP-SMX exhibited a significant improvement. This case indicates that even immunocompetent individuals may develop recurrent and refractory cystoisosporiasis. Furthermore, intravenous treatment of antibiotic agents should be considered when the impaired absorptive ability from the small intestine is suspected.
Identifiants
pubmed: 33725845
doi: 10.1097/MD.0000000000024890
pii: 00005792-202103120-00039
pmc: PMC7969258
doi:
Substances chimiques
Antiprotozoal Agents
0
Trimethoprim, Sulfamethoxazole Drug Combination
8064-90-2
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e24890Subventions
Organisme : Japan Society for the Promotion of Science
ID : JP19K23844
Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors state that they have no conflict of interest.
Références
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