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在一名来自德黑兰的腹泻艾滋病病毒阳性/艾滋病患者中检测到新出现的卡耶塔环孢子虫:病例报告

Detection of Emergence Cyclospora cayetanensis in A HIV(+) / AIDS Patient with Diarrhea from Tehran: A Case Report.

作者信息

Khanaliha Khadijeh, Mohebali Mehdi, Davoudi Setareh, Reza Hosseini Omid, Tarighi Fatemeh, Rezaeian Tahereh, Rezaeian Mostafa

机构信息

Dept. of Medical Parasitology and Mycology, School Of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Dept. of Infectious Diseases, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Public Health. 2015 Jun;44(6):865-8.

Abstract

Coccidian protozoa of Cyclospora cayetanensis are obligate intracellular apicomplexan parasites that infect the mucosal epithelium of the small intestine of immunocompetent and immunocompromised persons. A 25- years old woman from around, Tehran with complaint of faintness and fatigue with HIV positive/AIDS confirmed eight months ago was admitted in Imam Khomeini Hospital, Tehran, Iran in 2014. The patient suffered from intestinal and lung symptoms like watery diarrhea, flu-like symptoms. The stool was examined by direct preparation and concentration technique, stained with modified acid-fast staining method, and observed with light and then Immunofluorescence microscope. The stool cultivation was made in dichromate potassium medium and diagnosis of Cyclospora infection was finally made according to observation of Cyclospora oocysts almost 10 μm in acid-fast staining method and autofluorescence of Cyclospora under Immunofluorescence microscope. The patient was initially treated with azithromycin, tazocin and fluconazol because of lung lesions and diarrhea and relative remission was observed. Cyclospora sp. causes an intestinal infection particularly in immunocompromised patients.

摘要

卡耶塔环孢子球虫属于球虫纲原生动物,是专性细胞内寄生的顶复门寄生虫,可感染免疫功能正常和免疫功能低下人群的小肠黏膜上皮。一名来自德黑兰周边地区的25岁女性,8个月前确诊为HIV阳性/艾滋病,因头晕和疲劳前来就诊,于2014年入住伊朗德黑兰伊玛目霍梅尼医院。该患者出现肠道和肺部症状,如水样腹泻、流感样症状。粪便经直接涂片和浓缩技术检查,采用改良抗酸染色法染色,先在光学显微镜下观察,然后在免疫荧光显微镜下观察。粪便培养在重铬酸钾培养基中进行,最终根据抗酸染色法中观察到的近10μm的环孢子虫卵囊以及免疫荧光显微镜下环孢子虫的自发荧光确诊为环孢子虫感染。由于肺部病变和腹泻,该患者最初接受阿奇霉素、他唑仙和氟康唑治疗,并观察到相对缓解。环孢子虫属尤其在免疫功能低下患者中引起肠道感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e102/4524312/2d6c53e17bfb/IJPH-44-865-g001.jpg

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