Intestinal Cryptosporidiosis

Intestinal Cryptosporidiosis

    * Introduction
    * Symptoms and Diagnosis
    * Treatment
Human cryptosporidiosis is caused by infection with protozoans of the genus Cryptosporidium Apicomplexa. Human disease is believed to be caused by a single species but recent molecular studies have shown that there are several different species that cause human cryptosporidiosis. Some common species include Cryptosporidium hominis, for which natural host is humans, Cryptosporidium parvum, which infects cattle as humans.
Cryptosporidiosis mainly affects children. It causes a self-limiting diarrhea in healthy individuals. Cryptosporidiosis is also recognized as the cause of persistent diarrhea in children and prolonged severe diarrhea in people with AIDS. Source endemic cryptosporidiosis cases in the main route of transmission is fecal-oral interpersonal, but the infection may result and the animal-human transmission and the water. Endemiile major result from transmission through water.
Therapy includes administration of nitazoxanide, and azithromycin paromomicina that are partially active. Combination antiviral therapy including HIV protease inhibitor is associated with a dramatic improvement in many cases. Symptomatic therapy includes administration of fluids, nutrition and treatment with agents antimotilici. Cryptosporidiosis is an important cause of persistent diarrhea in developing countries. Children with persistent diarrhea develop malnutrition that cause cognitive problems that persist for years. Cryptosporidiosis may be complicated by chronic biliary tract disease, malabsorption and death in people with AIDS and malnourished children.
Pathogenesis and causes
Oocistii of Cryptosporidium are highly infectious, requiring only 10-1000 to cause human illness. Infectious dose is 100 in 50% of cases. Oocistii are immediately infectious and life cycle of the parasite produces forms that invade the intestine. Locating intracellular parasite in the intestine but extracitoplasmatica is contributing to a marked resistance to treatment of Cryptosporidium species. Oocisti large quantities are excreted and are resistant to adverse conditions, including chlorination levels used for water treatment. Cryptosporidium causes diarrhea Mecanismulo which includes a combination of increased intestinal permeability, chloride secretion and malabsorption caused by host response to infection. In immunocompetent persons the infection is usually self-limiting in the small intestine. In people with AIDS or congenital immunodeficiency, biliary tract may be affected.
The frequency of cryptosporidiosis is not well known. Over 30% of the adult population is HIV positive Su. The number of diagnosed cases increases with the improvement of tests, though, many laboratories do not routinely perform this test. Recent studies show that seat is HIV-positive in 4% of the cases submitted for examination coproparasitologic. Before the availability of antiretroviral therapy, approximately 10-15% of AIDS patients with cryptosporidiosis were developing in life. Like other opportunistic infections, the prevalence of cryptosporidiosis in patients with AIDS has dropped dramatically.