Brunet J, Lemoine J P, Pesson B, Valot S, Sautour M, Dalle F, Muller C, Borni-Duval C, Caillard S, Moulin B, Pfaff A W, Razakandrainibe R, Abou-Bacar A, Favennec L, Candolfi E
Laboratoire de Parasitologie et de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, BP 426, F-67091, Strasbourg cedex, France.
Institut de Parasitologie et Pathologie Tropicale, EA 7292, Fédération de Médecine Translationnelle, Université de Strasbourg, 3 rue Koeberlé, F-67000, Strasbourg, France.
BMC Infect Dis. 2016 Aug 2;16:363. doi: 10.1186/s12879-016-1661-5.
Cryptosporidium spp. is a ubiquitous parasite affecting humans as well as domestic and wild vertebrates, causing diarrhea in both immunocompetent and immunocompromised hosts worldwide. Its transmission occurs primarily by the fecal-oral route. In humans, C. parvum and C. hominis are the most prevalent species, whereas immunocompetent and immunocompromised individuals can also be infected by other zoonotic species. Renal transplant patients are prone to develop cryptosporidiosis, which can induce severe and life-threatening diarrhea.
We report here a series of nearly concomitant cases of acute symptomatic cryptosporidiosis in three renal transplant patients attending the Strasbourg University Hospital Nephrology Unit. The clinical presentation was persistent diarrhea and acute renal failure. The diagnosis was confirmed by microscopic stool examination using a modified Ziehl-Neelsen staining method and species identification by molecular tools. All patients were treated with nitazoxanide and recovered from diarrhea after 14 days of therapy.
Genotypic species identification was not consistent with an epidemic context, thus underlining the need for genotyping to monitor at risk patients.
隐孢子虫属是一种广泛存在的寄生虫，可感染人类以及家养和野生脊椎动物，在全球范围内导致免疫功能正常和免疫功能低下的宿主出现腹泻。其传播主要通过粪口途径。在人类中，微小隐孢子虫和人隐孢子虫是最常见的种类，而免疫功能正常和免疫功能低下的个体也可能被其他动物源性病原体感染。肾移植患者容易发生隐孢子虫病，可引发严重且危及生命的腹泻。
我们在此报告斯特拉斯堡大学医院肾脏病科收治的3例肾移植患者中一系列几乎同时发生的急性症状性隐孢子虫病病例。临床表现为持续性腹泻和急性肾衰竭。通过改良齐-尼染色法进行粪便显微镜检查并使用分子工具进行物种鉴定确诊。所有患者均接受硝唑尼特治疗，治疗14天后腹泻症状缓解。
基因型物种鉴定结果与流行情况不一致，因此强调需要进行基因分型以监测高危患者。
