trimethoprim--sulfamethoxazole-drug-combination and Cryptosporidiosis

AIDS is a disorder that the pediatrician must consider when evaluating children with a variety of clinical conditions, including overwhelming infection with a number of parasites. This article discusses these opportunistic parasitic infections, focusing on their link with AIDS.

Topics: Acquired Immunodeficiency Syndrome; Adult; Age Factors; Animals; Anti-Bacterial Agents; Antiprotozoal Agents; Child; Child, Preschool; Cryptosporidiosis; Drug Combinations; Female; gamma-Globulins; Homosexuality; Humans; Infant; Male; Parasitic Diseases; Pentamidine; Pneumonia, Pneumocystis; Sulfamethoxazole; Transfusion Reaction; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; United States; Zoonoses

The present study evaluated the therapeutic efficacy of azithromycin, co-trimoxazole and kalvangi (Nigella sativa, also known as Black Cumin) against Cryptosporidium parvum infection in calves under field conditions. The experimental calves were treated with azithromycin (group A) at 1500 mg/calf/day, co-trimoxazole (group B) at 30 mg Kg-1 and kalvangi seeds powder (group C) at 750 mg Kg-1 BW orally for 7 days. Calves in the group D were naturally infected with C. parvum , untreated animals (positive control) while the calves in the group E were uninfected negative control animals. A significant decrease (p < 0.05) in oocyst counts for calves in groups A, B and C was observed compared to group D. When the oocyst counts amongst the treatment groups A, B and C were compared, a significant decrease (p < 0.05) was observed in group A. On day 21 post-treatment, the efficacy of azithromycin, co-trimoxazole and kalvangi in calves was 88.2% (95% C.I. ± 15.4), 45% (95% C.I. ± 21.8) and 27.8% (95% C.I. ± 20.7), respectively. This study confirmed previous reports of azithromycin efficacy against C. parvum infection, but found co-trimoxazole and kalvangi to be ineffective for this infection under these treatment regimens.

Topics: Animals; Anti-Infective Agents; Azithromycin; Cattle; Cattle Diseases; Cryptosporidiosis; Cryptosporidium parvum; Feces; Female; Male; Nigella sativa; Parasite Egg Count; Phytotherapy; Plant Preparations; Powders; Seeds; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

A total prevalence of cryptosporidiosis was carried out on 1087 diarrheal patients of all age groups attending the outpatient clinics using modified Ziehl-Neelsen stain (MZN) and Meriflour direct immunofluorescent technique (IFA). IFA was more sensitive, specific and gave positive results 19.5% than MZN stain which gave a positivity 13.5% Cases were divided into 3 groups, each group was treated by one of nitazoxanid (NTZ), or co-trimoxazole or placebo. The most effective drug was NTZ which cured 39 patients (79.6%) out of 49 patients followed by co-trimoxazole that gave cure of 20 (41.6%) out of 48 patients. Placebo cured 20 (40%) out of 50 patients.

Topics: Adolescent; Adult; Anti-Infective Agents; Child; Child, Preschool; Cryptosporidiosis; Diarrhea; Egypt; Female; Fluorescent Antibody Technique, Direct; Humans; Infant; Male; Nitro Compounds; Prevalence; Sensitivity and Specificity; Thiazoles; Trimethoprim, Sulfamethoxazole Drug Combination

The first case of cyclosporosis in a non HIV-infected child in Thailand, co-infected with Cryptosporidium, was reported. The patient was a 3 year-old malnourished orphan who presented with fever, abdominal distension and relapsing diarrhea. There was no leukocyte in her stool, however, numerous Cyclospora and Cryptosporidium oocysts were identified by modified acid-fast staining. The illness was cured by co-trimoxazole and fluid therapy. More coccidial infections in Thailand may be detected if modified acid-fast staining is routinely performed.

Topics: Animals; Anti-Infective Agents; Child, Preschool; Cryptosporidiosis; Cryptosporidium; Cyclospora; Cyclosporiasis; Feces; Female; HIV Seronegativity; Humans; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Abdominal Pain; Acquired Immunodeficiency Syndrome; Acute Disease; Adult; Cholelithiasis; Cryptosporidiosis; Humans; Male; Pancreatitis; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: AIDS-Related Opportunistic Infections; Cryptosporidiosis; Drug Therapy, Combination; Humans; Male; Middle Aged; Respiratory Tract Infections; Spiramycin; Trimethoprim, Sulfamethoxazole Drug Combination

Ninety consecutive first-time fiberoptic bronchoscopies (FB) were performed on HIV-infected patients with pulmonary symptoms and radiographic evidence of active pneumonitis. Microbiological data were analysed for acute and long-term prognostic significance. 56/90 (63%) patients had one type of microbiological agent recovered from FB, 22/90 (24%) patients had more types recovered, and 12/90 (13%) patients had no types recovered. Nine patients (10%) died during the acute episode of pneumonia. A prognostic factor of a fatal outcome of the acute episode of pneumonia was concurrent multiple pulmonary infections (p = 0.002), mainly ascribed to patients with Pneumocystis carinii pneumonia (PCP) and concomitant bacterial pneumonia (p = 0.003). Specific microbiological findings at FB did not influence long-term survival of patients, and, when omitting patients who died during the acute episode of pneumonia (n = 9), no difference in survival was observed between patients with a) no agent, b) one type of agent or c) more types of agents recovered from FB. Only non-pulmonary parameters such as CD4-count, haemoglobin and age were found to be prognostic parameters. Thus, increased attention should be paid to co-pathogens presenting in HIV-infected patients with pulmonary infection and appropriate therapy instituted.

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Aged; Bronchoscopy; Cryptosporidiosis; Cytomegalovirus Infections; Ganciclovir; Humans; Male; Middle Aged; Pentamidine; Pneumonia; Pneumonia, Pneumocystis; Risk Factors; Survival Analysis; Trimethoprim, Sulfamethoxazole Drug Combination

To present the findings of Isospora belli infection in two patients with the acquired immunodeficiency syndrome (AIDS).. One patient was part Aboriginal, the other an immigrant recently arrived from Peru. Both men were infected with the human immunodeficiency virus (HIV). They presented with watery diarrhoea, one with severe weight loss. Isospora belli oocysts were detected in multiple faecal specimens from both patients. One patient had a concomitant infection with Cryptosporidium sp.. There was a rapid response to treatment with cotrimoxazole (960 mg, four times a day for 10 days). A complete response was obtained in the patient with concurrent cryptosporidiosis. The diarrhoea recurred after cessation of treatment, necessitating maintenance therapy.. Although Isospora belli is an uncommon cause of gastroenteritis in Australia, it is increasingly recognised as a cause of diarrhoea in travellers, immigrants from endemic areas and immunocompromised people. It has also been reported in the Aboriginal community; this article reports the first case of AIDS-related isosporiasis in an Aborigine. It is likely that both patients acquired Isospora belli before they become HIV seropositive.

Topics: Acquired Immunodeficiency Syndrome; Adult; Coccidiosis; Cryptosporidiosis; Diarrhea; Gastroenteritis; Humans; Male; Trimethoprim, Sulfamethoxazole Drug Combination

The study of 11 cases of isosporiasis (Isospora belli) shows that this opportunistic coccidia, alone or with Cryptosporidium, causes severe prolonged diarrhoea which worsens the prognosis and evolution of AIDS patients. A low prevalence (0.7%) is found in subjects from tropical regions. The results of treatment are disappointing. Bactrim is the only drug found to be effective but prolonged parasitological surveillance is required to detect the frequent relapses, and assess the long-time usefulness of this drug.

Topics: Acquired Immunodeficiency Syndrome; Adult; Anti-Infective Agents; Coccidiosis; Cryptosporidiosis; Diarrhea; Drug Combinations; Female; Humans; Male; Opportunistic Infections; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Ten patients were identified at Jackson Memorial hospital/University of Miami Hospitals and Clinics with enteric coccidial infection due to Cryptosporidium spp. or Isospora belli. All had the acquired immunodeficiency syndrome as manifested by Kaposi's sarcoma or multiple opportunistic infections, or both. They presented with profuse diarrhea associated with weakness, anorexia, and weight loss. Routine examinations of stools for eggs and parasites as performed by the hospital laboratory were negative in all patients. Sugar flotation and modified acid fast techniques were used in the Tropical Disease Laboratory to identify oocysts of Cryptosporidium spp. in stools of seven patients. Malabsorption, characterized by a low 5-hour D-xylose and positive fecal fat, was observed in 6/6 of these patients. In three other patients Isospora belli oocysts were identified in stool specimens or via a duodenal string test. Spiramycin was the only drug found to be effective in treating patients with cryptosporidiosis. Patients with Isospora belli responded to a prolonged course of trimethoprim-sulfamethoxazole.

Topics: Acquired Immunodeficiency Syndrome; Adult; Animals; Coccidiosis; Cryptosporidiosis; Cryptosporidium; Diarrhea; Drug Combinations; Female; Furazolidone; Humans; Intestinal Diseases, Parasitic; Isospora; Leucomycins; Male; Middle Aged; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination