Co-Infection with Cryptosporidium meleagridis and Enterocytozoon bieneusi in an HIV+ Colombian Patient

ABSTRACT: A 44-year-old human immunodeficiency virus-infected (HIV+) female with severe immunodeficiency Category 3 (C3) diagnosed in 2010 was admitted to hospital with acute diarrhoea. She was non-adherent to antiretroviral therapy (ART) and had a previous suspicion of respiratory symptoms with a cough that had been persisting for 15 days. Clinical examination revealed severe immune deterioration (viral load: 109,655 copies/mL; CD4+ count: 14 cells/mm3), respiratory symptoms (negative sputum Gram stain and tuberculosis culture), and neurological deterioration (serological assays negative for Cryptococcus spp. and Toxoplasma gondii). A coproculture was negative for Campylobacter spp., Salmonella spp., and Shigella spp. Ziehl–Neelsen staining of faecal smears revealed the presence of Cryptosporidium spp. oocysts. PCR testing and sequencing confirmed a concomitant infection with C. meleagridis and Enterocytozoon bieneusi. The patient was treated with metronidazole (500 mg every 8 h for 5 days) and nitazoxanide (500 mg every 12 h for 14 days). After requesting voluntary discharge and abandoning ART and parasiticidal treatments, she experienced a dramatic deterioration of her state of health and contact with her was lost. Our results have demonstrated that molecular-based testing improves the detection of opportunistic pathogens that are difficult to detect by routine microscopy, allows for transmission dynamics investigations, and assists in choosing the best chemotherapeutical option.

• Autores: Hernández Castro, Carolina; Carmena Jiménez, David; Martinez Rosado, Larry Luber; Dashti, Alejandro; Köster, Pamela C.; Bailo, Begoña; Orozco, Maria C.; Santin, Mónica; González Barrio, David
• Fecha de publicación: 2023
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/44127
• Acceso en línea: https://hdl.handle.net/10495/44127
• Palabra clave: Infecciones Oportunistas; Opportunistic Infections; Cryptosporidium; Huésped Inmunocomprometido; Immunocompromised Host; Síndrome de Inmunodeficiencia Adquirida; Acquired Immunodeficiency Syndrome; VIH; HIV; Enterocytozoon; Medellín (Colombia); https://id.nlm.nih.gov/mesh/D009894; https://id.nlm.nih.gov/mesh/D003458; https://id.nlm.nih.gov/mesh/D016867; https://id.nlm.nih.gov/mesh/D000163; https://id.nlm.nih.gov/mesh/D006678; https://id.nlm.nih.gov/mesh/D021862
• Rights: openAccess
• License: https://creativecommons.org/licenses/by/4.0/