A Case Report of Cryptosporidiosis and Isosporiasis in AIDS Patients in Iran

Summary Cryptosporidiosis and isosporiasis are self-limiting enteric diseases caused by the protozoan parasites Cryptosporidium spp and Isospora spp, respectively. While immunocompetent individuals readily clear Cryptosporidium, immunocompromised individuals may experience sustained infection with significant severity. As a result, chronic cryptosporidiosis is responsible for considerable morbidity and some mortality among AIDS patients. Both cryptosporidiosis and isosporiasis display many similarities in their clinical symptoms, including watery diarrhea, stomach pains, and weight loss. In this study, in Tehran, Iran, 23 hospitalized AIDS patients were investigated. Stool samples were collected, fixed and examined by acid-fast staining (AFS), auramin phenol fluorescence (APF), and direct fluorescence using monoclonal antibody (DF × mAb). The results confirmed two cases (8.7%) infected with Cryptosporidium spp, one of whom (4.3%) was infected with Isospora spp. This is the first report of cryptosporidiosis and isosporiasis co-infection in AIDS patients suffering from diarrhea in Iran. Patients having normal stool consistency showed no oocysts of either sporozoa. Despite the consensus of opinion regarding the seriousness of Cryptosporidium and Isospora infections in AIDS patients, and the importance of protecting these patients from infection, there is insufficient understanding of the risk of fatal opportunistic protozoan parasites among them. Keywords : AIDS; Cryptosporidium; Isospora; co-infection; Iran