Intestinal parasitic infections in leukemic patients with diarrhea
Year 2017,
Volume: 07 Issue: 02, 63 - 66, 01.06.2017
Serhat Uysal, Eylem Akdur, Varol Tunalı, Ayşe Uysal, Ayşegül Ünver, Güray Saydam, Meltem Taşbakan, Hüsnü Pullukçu, Nevin Turgay, Bilgin Arda
Abstract
Objectives: Leukemic patients are at increased risk of severe infections with parasites. Moreover, intestinal parasites
can lead to severe diarrhea in patients with immunosuppression. The purpose of this study is to decide intestinal
parasitic infections and clinical aspects in leukemic patients.
Methods: Analysis was done of all leukemic patients hospitalized between January 2007 and October 2015
retrospectively.
Results: Ninety-one patients were evaluated. Intestinal parasites were diagnosed in nine (9.9%) patient.
Cryptosporidium was the most frequently identified parasite, recovered from six specimens (6.6%), while Blastocystis
(n=3) and Entamoeba (n=1) accounted for 3.3% and 1.1%, respectively. Cryptosporidium spp. and E. histolytica were
detected together in one patient. Duration of diarrhea in patients with and without parasite were 16.1±9.3 and
7.9±2.9days, respectively (P=0.037). Abdominal cramps in patients with and without parasite were present in seven
(77.8%) and 20 (24.4%) patients, respectively (P=0.002). In contrast, vomiting in patient with and without parasite
were present in five (55.6%) and 81 (98.8%) patients, respectively (P<0.0005).
Conclusion: Parasitic infections should be considered for differential diagnosis in leukemic patients with diarrhea. J
Microbiol Infect Dis 2017; 7(2): 63-66
References
- 1. Alıcı O, Akbas E, Alıcı S. Opportunistic infections in cancer patients. Turk J Oncol. 2008;23:153- 162.
- 2. Pala C, Kaynar L, Buyukoglan R, et al. Diarrhea in peripheral stem cell transplant recipients: a developing country's experience. J Infect Dev Ctries 2014;8:635-641.
- 3. Yasuoka A. Opportunistic infections in HIV/AIDS. Nihon Rinsho 2010;68:486-490.
- 4. Buiuc D. Pathogenic opportunistic microorganisms. Bacteriol Virusol Parazitol Epidemiol 1995; 40:3-7.
- 5. Thienemann F, Sliwa K, Rockstroh JK. HIV and the heart: the impact of antiretroviral therapy: a global perspective. Eur Heart J 2013; 34:3538- 3546.
- 6. Podzamczer D. Lipid metabolism and cardiovascular risk in HIV infection: new perspectives and the role of nevirapine. AIDS Rev 2013; 15:195-203.
- 7. Ditrich O. Basic laboratory methods in medical parasitology. 1991 World Health Organization, Geneva. Folia Parasitol. 1993;40:306.
- 8. Garcia LS: Macroscopic and Microscopic Examination of Fecal Specimens. In: Diagnostic Medical Parasitology. Fifth Edition edn. Edited by Garcia LS: American Society of Microbioly 2007: 782-830.
- 9. Weber R, Bryan RT, Owen RL, Wilcox CM, Gorelkin L, Visvesvara GS. Improved lightmicroscopical detection of microsporidia spores in stool and duodenal aspirates. The Enteric Opportunistic Infections Working Group. N Engl J Med 1992;326:161-166.
- 10. Dogan N, Demirustu C, Aybey A. The prevalence of intestinal parasites according to the distribution of the patients' gender and parasite species for five years at the Osmangazi University Medical Faculty. Turkiye Parazitoloji Dergisi 2008;32:120- 125.
- 11. Çolak H. Türkiye' de bağırsak parazitlerinin bölgesel yaygınlığı. Mikrobiyoli Bulteni 1979; 13:115-127.
- 12. Shebl FM, Engels EA, Goedert JJ. Opportunistic intestinal infections and risk of colorectal cancer among people with AIDS. AIDS Res Hum Retroviruses 2012; 28:994-999.
- 13. Feasey NA, Healey P, Gordon MA. Review article: the aetiology, investigation and management of diarrhoea in the HIV-positive patient. Aliment Pharmacol Ther 2011;34:587-603.
- 14. Legrand F, Grenouillet F, Larosa F, et al. Diagnosis and treatment of digestive cryptosporidiosis in allogeneic haematopoietic stem cell transplant recipients: a prospective single centre study. Bone Marrow Transplant 2011; 46:858-862.
- 15. Gentile G, Venditti M, Micozzi A, et al. Cryptosporidiosis in patients with hematologic malignancies. Rev Infect Dis 1991;13:842-846.
- 16. Cimerman S, Cimerman B, Lewi DS. Prevalence of intestinal parasitic infections in patients with acquired immunodeficiency syndrome in Brazil. Int J Infect Dis 1999;3:203-206.
- 17. Martinez Perez A, Justiniani Cedeno NE. [incidence of intestinal parasites in pediatric patients with hematologic neoplasms from 1 to 15 years of age]. Rev Alerg Mex 1999;46:26-29.
- 18. Botero JH, Castano A, Montoya MN, Ocampo NE, Hurtado MI, Lopera MM. A preliminary study of the prevalence of intestinal parasites in immunocompromised patients with and without gastrointestinal manifestations. Rev Inst Med Trop Sao Paulo 2003; 45:197-200.
- 19. Aksoy U, Erbay A, Akisu C, Apa H, Ozkoc S, Ozturk S. Intestinal parasites in children with neoplasms. Turk J Pediatr 2003; 45:129-132.
Year 2017,
Volume: 07 Issue: 02, 63 - 66, 01.06.2017
Serhat Uysal, Eylem Akdur, Varol Tunalı, Ayşe Uysal, Ayşegül Ünver, Güray Saydam, Meltem Taşbakan, Hüsnü Pullukçu, Nevin Turgay, Bilgin Arda
References
- 1. Alıcı O, Akbas E, Alıcı S. Opportunistic infections in cancer patients. Turk J Oncol. 2008;23:153- 162.
- 2. Pala C, Kaynar L, Buyukoglan R, et al. Diarrhea in peripheral stem cell transplant recipients: a developing country's experience. J Infect Dev Ctries 2014;8:635-641.
- 3. Yasuoka A. Opportunistic infections in HIV/AIDS. Nihon Rinsho 2010;68:486-490.
- 4. Buiuc D. Pathogenic opportunistic microorganisms. Bacteriol Virusol Parazitol Epidemiol 1995; 40:3-7.
- 5. Thienemann F, Sliwa K, Rockstroh JK. HIV and the heart: the impact of antiretroviral therapy: a global perspective. Eur Heart J 2013; 34:3538- 3546.
- 6. Podzamczer D. Lipid metabolism and cardiovascular risk in HIV infection: new perspectives and the role of nevirapine. AIDS Rev 2013; 15:195-203.
- 7. Ditrich O. Basic laboratory methods in medical parasitology. 1991 World Health Organization, Geneva. Folia Parasitol. 1993;40:306.
- 8. Garcia LS: Macroscopic and Microscopic Examination of Fecal Specimens. In: Diagnostic Medical Parasitology. Fifth Edition edn. Edited by Garcia LS: American Society of Microbioly 2007: 782-830.
- 9. Weber R, Bryan RT, Owen RL, Wilcox CM, Gorelkin L, Visvesvara GS. Improved lightmicroscopical detection of microsporidia spores in stool and duodenal aspirates. The Enteric Opportunistic Infections Working Group. N Engl J Med 1992;326:161-166.
- 10. Dogan N, Demirustu C, Aybey A. The prevalence of intestinal parasites according to the distribution of the patients' gender and parasite species for five years at the Osmangazi University Medical Faculty. Turkiye Parazitoloji Dergisi 2008;32:120- 125.
- 11. Çolak H. Türkiye' de bağırsak parazitlerinin bölgesel yaygınlığı. Mikrobiyoli Bulteni 1979; 13:115-127.
- 12. Shebl FM, Engels EA, Goedert JJ. Opportunistic intestinal infections and risk of colorectal cancer among people with AIDS. AIDS Res Hum Retroviruses 2012; 28:994-999.
- 13. Feasey NA, Healey P, Gordon MA. Review article: the aetiology, investigation and management of diarrhoea in the HIV-positive patient. Aliment Pharmacol Ther 2011;34:587-603.
- 14. Legrand F, Grenouillet F, Larosa F, et al. Diagnosis and treatment of digestive cryptosporidiosis in allogeneic haematopoietic stem cell transplant recipients: a prospective single centre study. Bone Marrow Transplant 2011; 46:858-862.
- 15. Gentile G, Venditti M, Micozzi A, et al. Cryptosporidiosis in patients with hematologic malignancies. Rev Infect Dis 1991;13:842-846.
- 16. Cimerman S, Cimerman B, Lewi DS. Prevalence of intestinal parasitic infections in patients with acquired immunodeficiency syndrome in Brazil. Int J Infect Dis 1999;3:203-206.
- 17. Martinez Perez A, Justiniani Cedeno NE. [incidence of intestinal parasites in pediatric patients with hematologic neoplasms from 1 to 15 years of age]. Rev Alerg Mex 1999;46:26-29.
- 18. Botero JH, Castano A, Montoya MN, Ocampo NE, Hurtado MI, Lopera MM. A preliminary study of the prevalence of intestinal parasites in immunocompromised patients with and without gastrointestinal manifestations. Rev Inst Med Trop Sao Paulo 2003; 45:197-200.
- 19. Aksoy U, Erbay A, Akisu C, Apa H, Ozkoc S, Ozturk S. Intestinal parasites in children with neoplasms. Turk J Pediatr 2003; 45:129-132.