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Respiratory cryptosporidiosis: Case series and review of the literature

Kryptosporidiose der Atemwege: Fallserie und Literaturübersicht

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Summary

Five case of intestinal cryptosporidiosis with pulmonary involvement in patients with AIDS are reported. The diagnosis was based on the recognition of acid-fast oocysts in sputum or aspirated bronchial material and stool specimens. Coughing and excess secretions were present in all cases. Four patients had other associated pulmonary pathogens: twoMycobacterium tuberculosis, oneMycobacterium fortuitum and one Cytomegalovirus +Pneumocystis carinii; all of them had a previous (three cases) or simultaneous (one case) diagnosis of intestinal cryptosporidiosis, presenting with diarrhoea and vomiting. In the fifth patientCryptosporidium was the only pulmonary pathogen found in a bronchial aspirate, and the onset of diarrhoea was 1 month after respiratory detection. Fifty-seven cases of respiratory cryptosporidiosis have been reported since 1980. In 17 of them, no other pathogen was found. Diarrhoea was present in 77% of the patients, cough in 77%, dyspnea in 58%, expectoration in 54%, fever in 45%, thoracic pain in 33%.

Zusammenfassung

Wir berichten über fünf Fälle von intestinaler Kryptosporidiose mit pulmonaler Beteiligung bei AIDS Patienten. Die Diagnose wurde durch den Nachweis von säurefesten Oozysten im Sputum oder aspiriertem Bronchialsekret und im Stuhl gestellt. Bei allen Patienten bestand Husten und Auswurf. Bei vier Patienten fand sich gleichzeitig eine Assoziation mit anderen Infektionen, in zwei Fällen durchMycobacterium tuberculosis, in einem Fall durchMycobacterium fortuitum und in einem Fall durch Cytomegalovirus plusPneumocystis carinii. Bei allen Patienten war eine vorbestehende (drei Fälle) oder gleichzeitige intestinale Kryptosporidiose vorhanden, die mit Durchfall und Erbrechen einherging. Bei dem fünften Patienten war im Bronchialsekret ausschließlichCryptosporidium nachzuweisen, die Diarrhoe setzte erst einen Monat nach Entdeckung des Erregers im Respirationstrakt ein. Seit 1980 wurden 57 Fälle von respiratorischer Kryptosporidiose publiziert. In 17 Fällen fand sich kein anderer Erreger. In je 77% der Fälle waren Diarrhoe und Husten, in 58% Atemnot, in 54% Auswurf, 45% Fieber und in 33% Schmerzen aufgetreten.

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References

  1. Ungar, B. L. P. Cryptosporidiosis in humans (Homo sapiens). In:Dubey, J. P., Speer, C. A., Fayer, R. (eds.): Cryptosporidiosis of man and animals. CRC Press, Florida 1990, pp. 59–81.

    Google Scholar 

  2. Henriksen, S. A., Pohlenz, J. F. L. Staining of cryptosporidia by a modified Ziehl Neelsen technique. Acta Vet. Scand. 22 (1981) 594–596.

    Google Scholar 

  3. Young, K. H., Bullock, S. L., Melvin, D. M., Spruill, C. L. Ethyl acetate as a substitute for diethyl ether in the formalin-ether sedimentation technique. J. Clin. Microbiol. 10 (1979) 852–853.

    Google Scholar 

  4. Clinicopathological conference. Immunodeficiency and cryptosporidiosis. Br. Med. J. 281 (1980) 1123–1127.

    Google Scholar 

  5. Forgacs, P., Tarshis, A., Ma, P., Federman, M., Mele, L., Silverman, M. L., Shea, J. A. Intestinal and bronchial cryptosporidiosis in an immunodeficient homosexual male. Ann. Intern. Med. 99 (1983) 793–794.

    Google Scholar 

  6. Brady, E. M., Margolis, M. L., Korzeniowski, O. M. Pulmonary cryptosporidiosis in acquired immunodeficiency syndrome (AIDS). JAMA 252 (1984) 89–90.

    Google Scholar 

  7. Kocoshis, S. A., Cibull, M. L., Davis, T. E., Hinton, J. T., Seip, M., Banwell, J. G. Intestinal and pulmonary cryptosporidiosis in an infant with severe combined immunodeficiency. J. Pediatr. Gastroenterol. Nutr. 3 (1984) 149–157.

    Google Scholar 

  8. Ma, P., Villanueva, T. G., Kaufman, D., Gillooley, J. F. Respiratory cryptosporidiosis in the acquired immune deficiency syndrome: use of modified cold Kinyoun and hemacolor stains for rapid diagnoses. JAMA 252 (1984) 1298–1301.

    Google Scholar 

  9. Miller, R. A., Wasserheit, J. N., Kirihara, J., Coyle, M. B. Detection ofCryptosporidium oocysts in sputum during screening for mycobacteria. J. Clin. Microbiol. 20 (1984) 1192–1193.

    Google Scholar 

  10. Manivel, C., Filipovich, A., Snover, D. C. Cryptosporidiosis as a cause of diarrhea following bone marrow transplantation. Dis. Colon Rectum 28 (1985) 741–742.

    Google Scholar 

  11. Gross, T. L., Wheat, J., Bartlett, M., O'Connor, K. W. AIDS and multiple system involvement withCryptosporidium. Am. J. Gastroenterol. 81 (1986) 456–458.

    Google Scholar 

  12. Harari, M. D., West, B., Dwyer, B. Cryptosporidium as a cause of laryngotracheitis in an infant. Lancet i (1986) 1207.

    Google Scholar 

  13. Fernández Alonso, J., Andrada Becerra, E., Jordá Heras, M. M., Villar Rodríguez, J. L., Japón Rodríguez, J. L., León Lea, J. A. Criptosporidiosis intestinal con diseminación pancreatobiliar y bronquial en una niña afecta de síndrome de inmunodeficiencia adquirida. Med. Clin. (Barc.) 89 (1987) 335–338.

    Google Scholar 

  14. Gentile, G., Baldassarri, L., Caprioli, A., Donelli, G., Venditti, M., Avvisati, G., Martino, P. Colonic vascular invasion as a possible route of extraintestinal cryptosporidiosis. Am. J. Med. 82 (1987) 574–575.

    Google Scholar 

  15. Kibbler, C. C., Smith, A., Hamilton-Dutoit, S. J., Milburn, H., Pattinson, J. K., Prentice, H. G. Pulmonary cryptosporidiosis occurring in a bone marrow transplant patient. Scand. J. Infect. Dis. 19 (1987) 581–584.

    Google Scholar 

  16. O'Halloran, S. M., Murphy, N. P., Hart, C. A., Baxby, D., Smith, C. S. Fatal intestinal and pulmonary cryptosporidiosis in early infancy. Pediatric Rev. Commun. 2 (1987) 81–84.

    Google Scholar 

  17. Casals, A., Manterola, J. M., Ribelles, N., Clotet, B. Síndrome de inmunodeficiencia adquirida y criptosporidiasis de vías respiratorias. Med. Clin. (Barc.) 91 (1988) 676.

    Google Scholar 

  18. Davis, J. J., Heyman, M. B. Cryptosporidiosis and sinusitis in an immunodeficient adolescent. J. Infect. Dis. 158 (1988) 649.

    Google Scholar 

  19. Gari-Toussaint, M., Marty, P., Le Fichoux, Y., Pesce, A., Saint-Paul, M. C. Cryptosporidiose intestinale et pulmonaire temporairement asymptomatique chez un sidéen. Med. Mal. Infect. 18 (1988) 843–844.

    Google Scholar 

  20. Højlyng, N., Jensen, B. N. Respiratory cryptosporidiosis in HIV-positive patients. Lancet i (1988) 590–591.

    Google Scholar 

  21. Fernández, F. J., Sanz Hospital, J., Muñoz, T., Puigpelat, M. J., Gómez Mampaso, E. Hallazgo de quistes deCryptosporidium sp. en muestras respiratorias procesadas para micobacterias. XII Congreso de la Sociedad Española de Microbiología, Pamplona 1989, 2: 104.

    Google Scholar 

  22. Goodstein, R. S., Colombo, C. S., Illfelder, M. A., Skaggs, R. E. Bronchial and gastrointestinal cryptosporidiosis in AIDS. J. Am. Osteopath. Assoc. 89 (1989) 195–197.

    Google Scholar 

  23. Caballero, F., Sambeat, M. A., García Pachón, E., Puzo, C., Castella, J. Criptosporidiasis pulmonar y SIDA. Rev. Clin. Esp. 187 (1990) 371.

    Google Scholar 

  24. Travis, W. D., Schmidt, K., MacLowry, J. D., Masur, H., Condron, K. S., Fojo, A. T. Respiratory cryptosporidiosis in a patient with malignant lymphoma. Report of a case and review of the literature. Arch. Pathol. Lab. Med. 114 (1990) 519–522.

    Google Scholar 

  25. Fernández Sánchez, F. J., Puigpelat, M. J., Muñoz, T., Sanz-Hospital, J., Gómez Mampaso, E. La técnica de auramina O en muestras respiratorias: ¿sólo para micobacterias? Rev. Esp. Microbiol. Clin. 6 (1991) 394–398.

    Google Scholar 

  26. Fripp, P. J., Bothma, M. T., Crewe-Brown, H. H. Four years of cryptosporidiosis at GaRankuwa Hospital. J. Infec. 23 (1991) 93–100.

    Google Scholar 

  27. Jensen, B. N., Gerstoft, J., Skinhøj, P. The prognosis of HIV-infected patients with pneumonia. Dan. Med. Bull. 38 (1991) 468–470.

    Google Scholar 

  28. Martín Sánchez, A. M., Rodríguez Hernández, J., Fuertes Martín, A., Canut Blasco, A. Criptosporidiosis respiratoria: a propósito de un nuevo caso. Rev. Clin. Esp. 189 (1991) 300–301.

    Google Scholar 

  29. Moore, J. A., Frenkel, J. K. Respiratory and enteric cryptosporidiosis in humans. Arch. Pathol. Lab. Med. 115 (1991) 1160–1162.

    Google Scholar 

  30. Rodríguez Pérez, R., Fernández Pérez, B., Domínguez Álvarez, L. M., Naval Calviño, G. Criptosporidiosis respiratoria en pacientes VIH. Descripción de dos casos. Rev. Clin. Esp. 190 (1992) 210–211.

    Google Scholar 

  31. Brea Hernando, A. J., Bandrés Franco, E., Mosquera Lozano, J. D., Lantero Benedito, M., Ezquerra Lezcano, M. Criptosporidiasis pulmonar y SIDA. Presentación de un caso y revisión de la literatura. An. Med. Interna 10 (1993) 232–236.

    Google Scholar 

  32. Campayo Ibáñez, A., Lacruz Rodrigo, J. M., Valls Ferrer, J. M., Bonora Tamarit, V. Criptosporidiasis pulmonar en una paciente inmunocompetente. Med. Clin. (Barc.) 103 (1994) 237.

    Google Scholar 

  33. Mifsud, A. J., Bell, D., Shafi, M. S. Respiratory cryptosporidiosis as a presenting feature of AIDS. J. Infect. 28 (1994) 227–229.

    Google Scholar 

  34. López Vélez, R., Tarazona, R., García Camacho, A., Gómez Mampaso, E., Guerrero, A., Moreira, V., Villanueva, R. Intestinal and extraintestinal cryptosporidiosis in AIDS patients. Eur. J. Clin. Microbiol. Infect. Dis. 14 (1995) 677–681.

    Google Scholar 

  35. Mohri, H., Fujita, H., Asakura, Y., Katoh, K., Okamoto, R., Tanabe, J., Harano, H., Noguchi, T., Inayama, Y., Amano, T., Okubo, T. Case report: inhalation therapy of paromomycin is effective for respiratory infection and hypoxia byCryptosporidium with AIDS. Am. J. Med. Sci. 309 (1995) 60–62.

    Google Scholar 

  36. Dupont, C., Bougnoux, M. E., Turner, L., Rouveix, E., Dorra, M. Microbiological findings about pulmonary cryptosporidiosis in two AIDS patients. J. Clin. Microbiol. 34 (1996) 227–229.

    Google Scholar 

  37. Heine, J., Moon, H. W., Woodmansee, D. B., Pohlenz, J. F. L. Experimental tracheal and conjunctival infections withCryptosporidium sp. in pigs. Vet. Parasitol. 17 (1985) 17–25.

    Google Scholar 

  38. Meulbroek, J. A., Novilla, M. N., Current, W. L. An immunosuppressed rat model of respiratory cryptosporidiosis. J. Protozool. 38 (1991) 113S-115S.

    Google Scholar 

  39. Mascaro, C., Arnedo, T., Rosales, J. Respiratory cryptosporidiosis in a bovine. J. Parasitol. 80 (1994) 334–336.

    Google Scholar 

  40. Fleta, J., Sánchez Acedo, C., Clavel, A., Quílez, J. Detection ofCryptosporidium oocysts in extraintestinal tissues of sheep and pigs. Vet. Parasitol. 59 (1995) 201–205.

    Google Scholar 

  41. Shahid, N. S., Rahman, A. S. M. H., Anderson, B. C., Mata, L. J., Sanyal, S. C. Cryptosporidiosis in Bangladesh. Br. Med. J. 290 (1985) 114–115.

    Google Scholar 

  42. Weikel, C. S., Leah, I. J., De Sousa, M. A., Guerrant, R. L. Cryptosporidiosis in Northeastern Brazil: association with sporadic diarrhea. J. Inf. Dis. 151 (1985) 963–965.

    Google Scholar 

  43. Vidal, T., Gamboa, C., Henríquez, M. I., Biolley, A. Cryptosporidium: brote epidémico en un centro de recuperación nutricional, Temuco. Rev. Med. Chil. 119 (1991) 1136–1139.

    Google Scholar 

  44. Egger, M., Mausezahl, D., Odermatt, P., Marti, H. P., Tanner, M. Symptoms and transmission of intestinal cryptosporidiosis. Arch. Dis. Child 65 (1990) 445–447.

    Google Scholar 

  45. Sallon, S., el Showwa, R., el Masri, M., Khalil, M., Blundell, N., Hart, C. A. Cryptosporidiosis in children in Gaza. Ann. Trop. Paediatr. 11 (1991) 277–281.

    Google Scholar 

  46. Martínez, F., Mascaro, C., Rosales, M. J., Díaz, J., Cifuentes, J., Osuna, A. In vitro multiplication ofCryptosporidium parvum in mouse peritoneal macrophages. Vet. Parasitol. 42 (1992) 27–31.

    Google Scholar 

  47. Hójlyng, N., Holten-Andersen, W., Jepsen, S. Cryptosporidiosis: a case of airborne transmission. Lancet ii (1987) 271–272.

    Google Scholar 

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Authors and Affiliations

  1. Servicio de Microbiologia, Hospital Clínico Universitario, San Juan Bosco 15, E-50009, Zaragoza

    A. Clavel M.D., Ph.D., A. C. Arnal B.Sc., E. C. Sánchez M.D., F. J. Castillo M.D., Ph.D., M. Varea M.D. & R. Gómez-Lus M.D., Ph.D.

  2. Servicio de Enfermedades Infecciosas, Hospital Clínico Universitario, E-50009, Zaragoza, Spain

    J. Cuesta M.D., Ph.D., S. Letona M.D. & J. A. Amiguet M.D., Ph.D.

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Clavel, A., Arnal, A.C., Sánchez, E.C. et al. Respiratory cryptosporidiosis: Case series and review of the literature. Infection 24, 341–346 (1996). https://doi.org/10.1007/BF01716076

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