Severe Isospora (Cystoisospora) belli Diarrhea Preceding the Diagnosis of Human T-Cell-Leukemia-Virus-1-Associated T-Cell Lymphoma
Isospora (Cystoisospora) belli diarrhea can sometimes be fulminant in immunocompromised patients. It is endemic in tropical and subtropical areas, and sporadic episodes have been reported in nonendemic areas in nursing homes, day-care centers, and psychiatric institutions. We describe isosporiasis i...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2012-01-01
|
| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2012/640104 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832566662213140480 |
|---|---|
| author | N. Ud Din P. Torka R. E. Hutchison S. W. Riddell J. Wright A. Gajra |
| author_facet | N. Ud Din P. Torka R. E. Hutchison S. W. Riddell J. Wright A. Gajra |
| author_sort | N. Ud Din |
| collection | DOAJ |
| description | Isospora (Cystoisospora) belli diarrhea can sometimes be fulminant in immunocompromised patients. It is endemic in tropical and subtropical areas, and sporadic episodes have been reported in nonendemic areas in nursing homes, day-care centers, and psychiatric institutions. We describe isosporiasis in an HIV-negative Sudanese-American female who presented with a debilitating diarrheal illness and profound weight loss. Isospora belli was detected in her stool by modified acid-fast staining. Serologic testing was negative for HIV but positive for HTLV-1 infection. Treatment with TMP-SMZ led to improvement in her diarrhea which recurred after stopping antibiotics. Subsequently, she developed generalized lymphadenopathy which was diagnosed as ATLL on immunohistochemical staining. Chemotherapy was initiated, but her condition continued to worsen due to persistent diarrhea and resulting profound electrolyte abnormalities. The patient opted for comfort measures and died a few weeks later at a nursing facility. This case emphasizes that the detection of I. belli should trigger testing for HIV, HTLV-1, and other causes of immunocompromise. We suggest that treatment with TMP-SMZ should be initiated and continued for a prolonged period of time in immunocompromised patients with I. belli diarrhea. |
| format | Article |
| id | doaj-art-158f35ef4801463d9335222ea60d5521 |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-158f35ef4801463d9335222ea60d55212025-02-03T01:03:27ZengWileyCase Reports in Infectious Diseases2090-66252090-66332012-01-01201210.1155/2012/640104640104Severe Isospora (Cystoisospora) belli Diarrhea Preceding the Diagnosis of Human T-Cell-Leukemia-Virus-1-Associated T-Cell LymphomaN. Ud Din0P. Torka1R. E. Hutchison2S. W. Riddell3J. Wright4A. Gajra5Department of Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USADepartment of Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USADepartment of Pathology, SUNY Upstate Medical University, 750 Adams Street, Syracuse, NY 13210, USADepartment of Pathology, SUNY Upstate Medical University, 750 Adams Street, Syracuse, NY 13210, USADepartment of Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USADepartment of Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USAIsospora (Cystoisospora) belli diarrhea can sometimes be fulminant in immunocompromised patients. It is endemic in tropical and subtropical areas, and sporadic episodes have been reported in nonendemic areas in nursing homes, day-care centers, and psychiatric institutions. We describe isosporiasis in an HIV-negative Sudanese-American female who presented with a debilitating diarrheal illness and profound weight loss. Isospora belli was detected in her stool by modified acid-fast staining. Serologic testing was negative for HIV but positive for HTLV-1 infection. Treatment with TMP-SMZ led to improvement in her diarrhea which recurred after stopping antibiotics. Subsequently, she developed generalized lymphadenopathy which was diagnosed as ATLL on immunohistochemical staining. Chemotherapy was initiated, but her condition continued to worsen due to persistent diarrhea and resulting profound electrolyte abnormalities. The patient opted for comfort measures and died a few weeks later at a nursing facility. This case emphasizes that the detection of I. belli should trigger testing for HIV, HTLV-1, and other causes of immunocompromise. We suggest that treatment with TMP-SMZ should be initiated and continued for a prolonged period of time in immunocompromised patients with I. belli diarrhea.http://dx.doi.org/10.1155/2012/640104 |
| spellingShingle | N. Ud Din P. Torka R. E. Hutchison S. W. Riddell J. Wright A. Gajra Severe Isospora (Cystoisospora) belli Diarrhea Preceding the Diagnosis of Human T-Cell-Leukemia-Virus-1-Associated T-Cell Lymphoma Case Reports in Infectious Diseases |
| title | Severe Isospora (Cystoisospora) belli Diarrhea Preceding the Diagnosis of Human T-Cell-Leukemia-Virus-1-Associated T-Cell Lymphoma |
| title_full | Severe Isospora (Cystoisospora) belli Diarrhea Preceding the Diagnosis of Human T-Cell-Leukemia-Virus-1-Associated T-Cell Lymphoma |
| title_fullStr | Severe Isospora (Cystoisospora) belli Diarrhea Preceding the Diagnosis of Human T-Cell-Leukemia-Virus-1-Associated T-Cell Lymphoma |
| title_full_unstemmed | Severe Isospora (Cystoisospora) belli Diarrhea Preceding the Diagnosis of Human T-Cell-Leukemia-Virus-1-Associated T-Cell Lymphoma |
| title_short | Severe Isospora (Cystoisospora) belli Diarrhea Preceding the Diagnosis of Human T-Cell-Leukemia-Virus-1-Associated T-Cell Lymphoma |
| title_sort | severe isospora cystoisospora belli diarrhea preceding the diagnosis of human t cell leukemia virus 1 associated t cell lymphoma |
| url | http://dx.doi.org/10.1155/2012/640104 |
| work_keys_str_mv | AT nuddin severeisosporacystoisosporabellidiarrheaprecedingthediagnosisofhumantcellleukemiavirus1associatedtcelllymphoma AT ptorka severeisosporacystoisosporabellidiarrheaprecedingthediagnosisofhumantcellleukemiavirus1associatedtcelllymphoma AT rehutchison severeisosporacystoisosporabellidiarrheaprecedingthediagnosisofhumantcellleukemiavirus1associatedtcelllymphoma AT swriddell severeisosporacystoisosporabellidiarrheaprecedingthediagnosisofhumantcellleukemiavirus1associatedtcelllymphoma AT jwright severeisosporacystoisosporabellidiarrheaprecedingthediagnosisofhumantcellleukemiavirus1associatedtcelllymphoma AT agajra severeisosporacystoisosporabellidiarrheaprecedingthediagnosisofhumantcellleukemiavirus1associatedtcelllymphoma |