Tandon Nidhi, Gupta Sudeep
Department of Medical Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
Indian J Med Paediatr Oncol. 2014 Jan;35(1):93-5. doi: 10.4103/0971-5851.133731.
Cryptosporidiosis is a protozoal infection that leads to self-limited diarrheal disease in immunocompetent individuals and a more severe illness in immunocompromised patients especially those infected with the human immunodeficiency virus. Although patients with hematolymphoid malignancies can develop this infection, it is an uncommon cause of diarrhea in these patients. The patient was a 64-year-old woman, a known case of multiple myeloma for 17 years, who had been treated with multiple lines of chemotherapy earlier. She was being treated with lenalidomide plus dexamethasone for active myeloma at the time of this episode. She presented with profuse watery diarrhea of 15 days duration that was proven to be due to Cryptosporidium parvum on stool examination. The diarrheal illness resolved after treatment with nitazoxanide. Although uncommon, cryptosporidial infection should be suspected in patients with hematological malignancies who have persistent diarrhea. Stool examination with the modified acid-fast Kenyoun stain establishes the diagnosis in the majority of cases. Antiparasitic treatment is effective in controlling the infection.
隐孢子虫病是一种原生动物感染，在免疫功能正常的个体中会导致自限性腹泻疾病，而在免疫功能低下的患者中，尤其是感染了人类免疫缺陷病毒的患者中会引发更严重的疾病。虽然血液淋巴系统恶性肿瘤患者可能会发生这种感染，但在这些患者中它是腹泻的罕见病因。该患者是一名64岁女性，已知患有多发性骨髓瘤17年，此前已接受多线化疗。此次发病时，她正在接受来那度胺加地塞米松治疗活动性骨髓瘤。她出现了持续15天的大量水样腹泻，粪便检查证实是由微小隐孢子虫引起的。用硝唑尼特治疗后腹泻疾病得到缓解。虽然罕见，但对于患有血液系统恶性肿瘤且持续腹泻的患者应怀疑隐孢子虫感染。使用改良抗酸Kenyoun染色进行粪便检查在大多数病例中可确立诊断。抗寄生虫治疗对控制感染有效。
