Cryptosporidium infection in patients with primary immunodeficiencies

J Pediatr Gastroenterol Nutr. 2007 Oct;45(4):458-64. doi: 10.1097/MPG.0b013e318054b09b.

Abstract

Background: Cryptosporidium species infection is usually self-limited in immunocompetent populations, but can be severe and life-threatening among immunocompromised individuals, particularly in patients with AIDS and in these patients with primary immunodeficiencies (PIDs).

Patients and methods: A group of 5 patients with genetically confirmed hyper-IgM syndrome type 1 (XHIM) and one patient with primary CD4 lymphopenia were enrolled in the study. At least 2 stool samples and a bile sample in one patient were examined for Cryptosporidium oocysts by a modified Ziehl-Neelsen technique, by immunofluorescence assay using a commercial kit, as well as by molecular analysis followed by genotyping. Immunological status at the time of PID diagnosis and the complex picture of disease are presented.

Results: Chronic cryptosporidiosis was confirmed in 3 patients with XHIM and in one patient with primary CD4 lymphopenia. Molecular diagnosis showed the presence of C parvum, C hominis, and C meleagridis in analyzed specimens.

Conclusions: Cryptosporidium infection with serious clinical symptoms observed in patients with hyper-IgM syndrome calls for regular, repeated screening in this group of patients.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Bacterial Agents / administration & dosage
  • Azithromycin / administration & dosage
  • Child
  • Child, Preschool
  • Cryptosporidiosis / complications
  • Cryptosporidiosis / diagnosis*
  • Cryptosporidiosis / drug therapy
  • Cryptosporidium / isolation & purification*
  • Fatal Outcome
  • Female
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Hyper-IgM Immunodeficiency Syndrome / complications
  • Hyper-IgM Immunodeficiency Syndrome / immunology
  • Hyper-IgM Immunodeficiency Syndrome / therapy
  • Immunocompromised Host
  • Immunoglobulins / administration & dosage
  • Immunologic Deficiency Syndromes / complications*
  • Immunologic Deficiency Syndromes / immunology
  • Immunologic Deficiency Syndromes / therapy
  • Infant
  • Male
  • Paromomycin / administration & dosage
  • Poland
  • Retrospective Studies
  • T-Lymphocytopenia, Idiopathic CD4-Positive / complications
  • T-Lymphocytopenia, Idiopathic CD4-Positive / immunology
  • T-Lymphocytopenia, Idiopathic CD4-Positive / therapy

Substances

  • Anti-Bacterial Agents
  • Immunoglobulins
  • Paromomycin
  • Azithromycin