trimethoprim--sulfamethoxazole-drug-combination and Intestinal-Diseases--Parasitic

Topics: Animals; Coccidiosis; Diagnosis, Differential; Humans; Intestinal Diseases, Parasitic; Isospora; Prognosis; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Amebicides; Antimalarials; Antiprotozoal Agents; Balantidiasis; Chloroquine; Coccidiosis; Dientamoebiasis; Drug Combinations; Dysentery, Amebic; Emetine; Furans; Furazolidone; Giardiasis; Humans; Intestinal Diseases, Parasitic; Iodoquinol; Liver Abscess, Amebic; Metronidazole; Paromomycin; Quinacrine; Sulfamethoxazole; Tetracycline; Tinidazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

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.

Topics: Administration, Intravenous; Administration, Oral; Antiprotozoal Agents; Capsule Endoscopy; Chronic Disease; Diarrhea; Humans; Immunocompetence; Intestinal Diseases, Parasitic; Isosporiasis; Male; Middle Aged; Recurrence; Trimethoprim, Sulfamethoxazole Drug Combination

Intestinal parasites infections are endemic in Gabon. Nevertheless, they are rarely described in people living with HIV (PLHIV).. The frequency of intestinal parasite infection was estimated and compared between HIV-positive and HIV uninfected individuals in Gabon; factors associated with intestinal parasites were also analysed.. Using a cross-sectional study design sociodemographic data, life style habits, antiretroviral therapy, cotrimoxazole use and CD4 cell count were recorded.. Stool samples from participants living in Koulamoutou and Oyem were analysed using microscopy. Chi-squared or fisher's exact tests and logistic regression were performed.. Among participants (n=332), female gender was predominant (73.7%; n=135/183) and the median age was 45 [33-57] years old. Among 183 samples, 53.6% (n = 98/183) were infected by intestinal parasites. The proportion was higher (72.1%) in HIV negative participants compared to PLHIV (42.6%) (p <0.01). PLHIV were more frequently poly-infected. Infection was frequent in patients using external toilets and tap water (>70.0%).. Prevalence of intestinal parasites is higher in seronegative participants but polyparasitism is more frequent in PLHIV. Strategies are focused on HIV negative population, but this study shows the importance of sensitization for PLHIV to improve their quality of life.

Topics: Adolescent; Adult; Antiretroviral Therapy, Highly Active; Carrier State; Coinfection; Cross-Sectional Studies; Feces; Female; Gabon; HIV Infections; Humans; Intestinal Diseases, Parasitic; Male; Middle Aged; Prevalence; Quality of Life; Risk Factors; Rural Population; Trimethoprim, Sulfamethoxazole Drug Combination

Intestinal parasitic infections are among the most common communicable diseases worldwide, particularly in developing countries. Human immunodeficiency virus (HIV) causes dysregulation of the immune system through the depletion of CD4+ T lymphocytes which gives rise to opportunistic infections.. A cross-sectional study was conducted from January to October 2018. Stool and blood samples were collected from participants aged 1 to 19. Stool samples were analyzed for intestinal parasites. Blood samples were analyzed for HIV and CD4 + T cell counts.. Out of 214 children enrolled, 119 (55.6%) were HIV infected and 95 (44.4%) were HIV non-infected. All infected children were on antiretroviral treatment (ART). The prevalence of intestinal parasites was 20.2% in HIV infected and 15.8% in non-infected children. Among the 119 HIV infected children, 33 (27.7%) of them had a CD4+ T cell count less than 500 cells/mm3, and amongst them 5.9% had CD4+ T cell count less than 200 cells/mm3. Among HIV infected children, Cryptosporidium spp. was frequently detected, 7/119 (5.9%), followed by Giardia lamblia 5/119 (4.2%) then Blastocystis hominis 3/119 (2.5%) and Entamoeba coli 3/119 (2.5%). Participants on ART and prophylactic co-trimoxazole for >10 years had little or no parasite infestation.. Although ART treatment in combination with prophylactic co-trimoxazole reduces the risk of parasitic infection, 20.2% of HIV infected children harbored intestinal parasites including Cryptosporidium spp. Stool analysis may be routinely carried out in order to treat detected cases of opportunistic parasites and such improve more on the life quality of HIV infected children.

Topics: Adolescent; AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Anti-Retroviral Agents; Antibiotic Prophylaxis; Antiretroviral Therapy, Highly Active; Blastocystis hominis; Cameroon; Candida; Child; Child, Preschool; Cross-Sectional Studies; Cryptosporidium; Entamoeba; Feces; Female; Giardia lamblia; HIV Infections; Humans; Infant; Intestinal Diseases, Parasitic; Male; Prevalence; Trimethoprim, Sulfamethoxazole Drug Combination

To determine the incidence of Isospora belli infection in HIV-infected patients in France, and to study risk factors.. The French Hospital Database on HIV (FHDH) is a prospective cohort study that collects demographic, clinical and therapeutic data on patients managed in 62 hospitals. We reviewed all cases of I. belli infection recorded between 1992 and 2003. We compared the incidence in 1992-1994 [before the use of dual therapy and combination antiretroviral therapy (cART)] and in 1997-2003 (when use of cART was widespread), after stratification for CD4 cell count (< 50, 50-99, 100-199 and > 200 cells/microL).. A total of 164 patients had I. belli infection either at enrollment (n=71) or during follow up (n=93). During the study period, I. belli infection tended to occur less frequently during follow up, and to be diagnosed mainly at database enrollment. The incidence of I. belli infection during follow up fell by 79% [relative hazard (RH) 0.21; 95% confidence interval (CI) 0.13-0.33] in the cART period compared with the pre-cART period; no such change was noted among patients with CD4 cell counts below 50 cells/microL. In multivariable analysis, the risk of I. belli infection was significantly higher among patients from sub-Saharan Africa (RH 4.3; 95% CI 2.6-7.3). After adjustment for CD4 cell count, patients receiving cotrimoxazole prophylaxis were found to be at a lower risk of I. belli infection (RH 0.3; 95% CI 0.2-0.6).. In France, I. belli infection among HIV-infected patients is now mainly seen in patients from sub-Saharan Africa, who present at an advanced stage.

Topics: Adult; Africa South of the Sahara; AIDS-Related Opportunistic Infections; Anti-Infective Agents; Anti-Retroviral Agents; CD4 Lymphocyte Count; Databases, Factual; Drug Therapy, Combination; Female; France; HIV Infections; HIV-1; Humans; Incidence; Intestinal Diseases, Parasitic; Isosporiasis; Male; Prospective Studies; Risk Factors; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Animals; Anti-Bacterial Agents; Antidiarrheals; Child, Preschool; Chronic Disease; Diarrhea; Drug Therapy, Combination; Eucoccidiida; Humans; Infant; Intestinal Diseases, Parasitic; Trimethoprim, Sulfamethoxazole Drug Combination

A detailed chronology of unsuccessful efforts to diagnose and treat a sudden-onset case of chronic diarrhea acquired in Jakarta Indonesia, and ultimately attributed to Cyclospora is presented. A modified Kato technique was used to quantify Cyclospora oocysts during successive days prior to, during, and after successful cotrimoxazole therapy (160 mg of trimethoprim, 800 mg sulfamethoxazole twice a day for seven days) for this infection. Cyclospora was associated with 6.4% of the gastrointestinal illness and/or diarrhea cases that presented during a seven-month period to a Jakarta clinic that serves a small population of expatriates. Cyclospora and Giardia lamblia were identified with equal frequency during this period and were the dominant pathogenic intestinal parasite species found in this community.

Topics: Animals; Anti-Infective Agents; Coccidiosis; Diarrhea; Eucoccidiida; Female; Humans; Indonesia; Intestinal Diseases, Parasitic; Middle Aged; Trimethoprim, Sulfamethoxazole Drug Combination; United States

Topics: Coccidiosis; Diarrhea; Humans; Intestinal Diseases, Parasitic; Trimethoprim, Sulfamethoxazole Drug Combination

Isosporiasis is an uncommon but important diarrheal disease of humans that, like cryptosporidiosis, is life-threatening in patients with the acquired immunodeficiency syndrome (AIDS). Isospora belli infection responds rapidly to therapy with trimethoprim-sulfamethoxazole, but patients with AIDS have a high rate of adverse reactions to this therapy. The cases of two patients with AIDS, sulfonamide allergy, and I. belli infection are reported. They were treated successfully with pyrimethamine alone, 75 mg/d, and recurrence was prevented with daily pyrimethamine therapy, 25 mg/d. In patients with AIDS with sulfonamide allergy or intolerance, pyrimethamine alone seems to be a reasonable alternative therapy for I. belli infection.

Topics: Adult; Coccidiosis; Diarrhea; Drug Combinations; HIV Seropositivity; Humans; Intestinal Diseases, Parasitic; Male; Middle Aged; Pyrimethamine; Recurrence; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Therapy of opportunistic infection in patients with the acquired immunodeficiency syndrome is frustrating, and there is no convincing evidence that aggressive treatment and/or prophylaxis other than for Pneumocystis infection can significantly prolong life. While much clinical effort is expended on treating sequential life-threatening infections, the overall course is usually progressively downhill. Thus, any real impact on the disease should be aimed at the causative viral agent, because it is destruction of a critical component of the immune system that predisposes to opportunistic infections.

Topics: Acquired Immunodeficiency Syndrome; Adult; Candidiasis; Cryptococcosis; Drug Combinations; Humans; Intestinal Diseases, Parasitic; Male; Mycobacterium Infections; Mycoses; Pneumonia, Pneumocystis; Sulfamethoxazole; Toxoplasmosis; Transfusion Reaction; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Virus Diseases

Topics: Child; Chronic Disease; Coccidiosis; Diarrhea; Drug Combinations; Female; Humans; Intestinal Diseases, Parasitic; 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

Topics: Adult; Chronic Disease; Coccidiosis; Drug Combinations; Giardia; Humans; Intestinal Diseases, Parasitic; Isospora; Male; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination