Diagnosis of Intestinal-Protozoa in Patients with Immune Deficiency
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Original Investigation
VOLUME: 32 ISSUE: 4
P: 328 - 333
December 2008

Diagnosis of Intestinal-Protozoa in Patients with Immune Deficiency

Turkiye Parazitol Derg 2008;32(4):328-333
1. Asker Hastanesi, Enfeksiyon Hastalıkları Kliniği, Kocaeli, Türkiye
2. Gülhane Askeri Tıp Akademisi Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye
3. Gülhane Askeri Tıp Akademisi Tıp Fakültesi, Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye
4. Gülhane Askeri Tıp Akademisi Tıp Fakültesi Haydarpaşa Eğitim Hastanesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İstanbul, Türkiye
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Received Date: 22.03.2008
Accepted Date: 10.06.2008
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ABSTRACT

In our study, we tried to detect gastroenteritis causing intestinal protozoa in patients with immune deficiency and who suffered from diarrhea. We also tried to determine which laboratory methods should be used in detecting intestinal protozoon in these patients. Thirty-six immune deficient patients who had had diarrhea for more than 10 days and 44 immune deficient patients without diarrhea were included in the study. In stool samples taken from all cases, intestinal protozoa were detected using the conventional diagnostic methods including direct wet mount, trichrome and modified acid fast staining as well as serologic diagnostic methods such as ELISA, direct fluorescent antibody (DFA)] and the molecular method of polymerized chain reaction. In our study, we found that intestinal protozoan such as G. intestinalis; C. parvum, B. hominis and E. histolytica could be responsible for the long term diarrhea in patients with immune deficiency. If a pathogen is not detected in the feces by native Lugol (NL), DFA and MAF are suitable techniques for Cryptosporidium spp while ELISA or trichrome staining are suitable methods for E. histolytica. It was concluded in the study that the simple and inexpensive NL method is sufficient in the diagnosis of G. intestinalis and serological or molecular methods are unnecessary. Neutropenia in patients with immune deficiency did not enhance the frequent occurrence of intestinal protozoan infections; and also, in the cases with immune deficiency, it was found that the administration of steroid treatment was not a risk factor in intestinal protozoan disease.

Keywords:
Protozoan infections, immune compromised patients