Cystoisosporiasis-related human acalculous cholecystitis: the need for increased awareness

Cholecystitis is one of the common surgical indications affecting human beings in many countries. A variety of infectious agents can be associated with acute or chronic acalculous cholecystitis, especially in HIV/AIDS patients. In this investigation, the authors aim to describe two cases of histologically and molecularly documented cystoisosporiasis (syn. isosporiasis) as the cause of chronic acalculous cholecystitis in two immunodeficient patients. During microscopic examinations of more than 2500 diarrheic patients’ samples, 11 cases of cystoisosporiasis-related recurrent persistent/chronic diarrhea were detected. A review of the medical records of Cystoisospora belli (syn. Isospora belli)-positive patients showed that two of them, i.e. a patient with prolonged corticosteroid therapy and an AIDS patient, several months prior to fecal examinations had undergone cholecystectomy due to acalculous cholecystitis. The study was continued by a review of the histopathological investigation of the recuts prepared from the excised gallbladder tissue sections and stained with hematoxylin and eosin in order to detect a possible specific clinical correlation with cystoisosporiasis. Light microscopic examination revealed the presence of various developmental stages of a coccidial parasite, namely Cystoisospora belli , in both patients’ gallbladder tissue sections. To the best of our knowledge, C. bellii -associated cholecystitis has not been previously reported in a patient with prolonged corticosteroid therapy

Prevalence of Gastrointestinal Coccidiosis in HIV/AIDS Patients in Fasa, Southwestern Iran

Background & Objective: Human immunodeficiency virus (HIV) infection has changed the epidemiology and prognosis of intestinal opportunistic parasitic infections. The present study was done to determine the prevalence of gastrointestinal coccidiosis in HIV/AIDS patients with gastroenteritis. Materials & Methods: This cross-sectional study was conducted at the Laboratory of HIV/AIDS Research Station of Fasa University of Medical Sciences, in southern Iran, from October 2013 to July 2020. Demographic data were collected by interviewing 68 participants (54 males and 14 females). Fecal samples were sent and examined for opportunistic parasites using wet mount, formalin-ethyl acetate method, acid-fast stain, nested polymerase chain reaction for the detection and confirmation of Cryptosporidium spp., Isospora belli, Cyclospora cayetanensis. Results: The findings confirmed 2 cases (2.9%) infected with Giardia cysts, 1 case (1.5%) infected with Entamoeba coli cysts and 1 case (1.5%) infected with Cryptosporidium and I. belli co-infection in a man suffering from gastroenteritis. Conclusion: This is the first detected case of gastroenteritis caused by co-infection of Cryptosporidium and I. belli in a man with AIDS occurring in the city of Fasa. If there are no other agents for gastroenteritis, the intestinal coccidiosis in such patients in Iran should not be ignored

Cystic fibrosis in a retro-positive child

We present a rare association of cystic fibrosis and retro positivity in a grossly malnutrited child. The child had pulmonary, pancreatic and colonic manifestations with superadded herpes simplex virus interstitial pneumonia and lymphocytic meningitis