Chacín-Bonilla L
Instituto de Investigaciones Clínicas, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela.
Invest Clin. 1995 Dec;36(4):207-50.
Cryptosporidiosis basically is a gastrointestinal infection caused by the coccidian protozoa Cryptosporidium. The infection is associated with diarrhea worldwide but it is most prevalent among children below 5 years of age in the undeveloped countries. It is an important Public Health problem. Infection in humans is usually with C. parvum. The parasite appears to be transmitted by a variety of mechanisms but zoonotic- and person-to-person transmission, and contaminated water appear to be the most important. The mechanism by which the coccidium causes diarrhea is unknown. The extent of the disease is mostly dependent on the immune status of the host. In immunocompetent persons, C. parvum may cause a short term diarrheal disease that resolves spontaneously; in immunocompromised patients, especially those with AIDS, produces a prolonged, life-threatening cholera-like disease. The diagnosis is generally made by detection of oocysts in stools by means of several concentration and staining procedures. Modified acid-fast and fluorescence stains are widely used. Immunofluorescent assays with Cryptosporidium-clonal antibodies have been developed to detect oocysts in stool specimens. Specific humoral antibodies have been detected by immunofluorescence and enzyme-linked immunosorbent assay techniques. Although an effective agent for Cryptosporidium is not available yet, promising results have been related to the immunotherapy. Vaccines are not available and the control and prevention of the infection is limited because of the environmentally resistant oocysts and the ignorance of all its possible transmission routes.
隐孢子虫病基本上是由球虫原生动物隐孢子虫引起的胃肠道感染。这种感染在全球范围内都与腹泻有关,但在不发达国家5岁以下儿童中最为普遍。它是一个重要的公共卫生问题。人类感染通常是由微小隐孢子虫引起的。该寄生虫似乎通过多种机制传播,但人畜共患病传播、人传人传播以及受污染的水似乎是最重要的传播途径。球虫引起腹泻的机制尚不清楚。疾病的严重程度主要取决于宿主的免疫状态。在免疫功能正常的人中,微小隐孢子虫可能会引起短期腹泻疾病,可自行痊愈;在免疫功能低下的患者中,尤其是艾滋病患者,会引发一种持续时间长、危及生命的霍乱样疾病。诊断通常是通过几种浓缩和染色程序检测粪便中的卵囊来进行的。改良抗酸染色和荧光染色被广泛使用。已经开发出用隐孢子虫克隆抗体进行的免疫荧光测定法来检测粪便标本中的卵囊。已经通过免疫荧光和酶联免疫吸附测定技术检测到特异性体液抗体。虽然目前还没有针对隐孢子虫的有效药物,但免疫疗法已取得了有希望的结果。目前还没有疫苗,由于卵囊对环境有抵抗力以及对其所有可能传播途径缺乏了解,感染的控制和预防受到限制。