Pulmonary Cryptosporidiosis in HIV Infected Patients at Imam Khomeini Complex Hospital in Tehran, Iran: A Case Series
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Abstract
Cryptosporidium species are a significant cause of persistent untreatable diarrhea in HIV-positive patients, especially in developing countries; however, extra-intestinal instances are rarely documented. Herein, we present three cases of pulmonary cryptosporidiosis in HIV patients at Imam Khomeini Hospital, Tehran, Iran. Despite the combination treatment with antiretroviral therapy, azithromycin, and paromomycin, the death of all 3 patients occurred due to severe complications. These cases highlight the importance of early diagnosis and management of respiratory cryptosporidiosis in HIV patients with low CD4 counts.
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10. Evering T, Weiss LM. The immunology of parasite infections in immunocompromised hosts. Parasite Immunol. 2006; 28(11):549-65.
11. Gupta S, Narang S, Nunavath V, Singh S. Chronic diarrhoea in HIV patients: prevalence of coccidian parasites. Indian J Med Microbiol. 2008; 26(2):172-5.
12. Wiwanitkit V. Intestinal parasitic infections in Thai HIV-infected patients with different immunity status. BMC Gastroenterol. 2001; 1: 3.
13. Adeyemo FE, Singh G, Reddy P, Stenström TA. Methods for the detection of Cryptosporidium and Giardia: From microscopy to nucleic acid-based tools in clinical and environmental regimes. Acta Trop. 2018; 184:15-28.
14. Kumar H, Singh VB, Meena BL, et al. Pulmonary cryptosporidiosis in an immunocompetent host treated successfully with nitazoxanide. Lung India. 2016; 33(1):69-71.
15. Gilbert IH, Vinayak S, Striepen B, et al. Safe and effective treatments are needed for cryptosporidiosis, a truly neglected tropical disease. BMJ Glob Health. 2023; 8(8): e012540.
2. Hunter PR, Nichols G. Epidemiology and clinical features of Cryptosporidium infection in immunocompromised patients. Clin Microbiol Rev. 2002; 15(1):145-54.
3. Meamar AR, Rezaian M, Rezaie S, Mohraz M, Kia EB, Houpt ER, Solaymani-Mohammadi S. Cryptosporidium parvum bovine genotype oocysts in the respiratory samples of an AIDS patient: efficacy of treatment with a combination of azithromycin and paromomycin. Parasitol Res. 2006; 98(6):593-5.
4. Sponseller JK, Griffiths JK, Tzipori S. The evolution of respiratory Cryptosporidiosis: evidence for transmission by inhalation. Clin Microbiol Rev. 2014; 27(3):575-86.
5. Albuquerque YM, Silva MC, Lima AL, Magalhães V. Pulmonary cryptosporidiosis in AIDS patients, an underdiagnosed disease. J Bras Pneumol. 2012; 38:530-2.
6. Park JH, Guk SM, Han ET, Shin EH, Kim JL, Chai JY. Genotype analysis of Cryptosporidium spp. prevalent in a rural village in Hwasun-gun, Republic of Korea. Korean J Parasitol. 2006; 44(1):27-33.
7. Pantenburg B, Cabada MM, White AC Jr. Treatment of cryptosporidiosis. Expert Rev Anti Infect Ther. 2009; 7(4):385-91.
8. Sullivan T, Reese L, Huprikar S, Lee M. Pulmonary cryptosporidiosis and immune reconstitution inflammatory syndrome: a case report and review. Int J STD AIDS. 2013; 24(4):333-4.
9. Goodstein RS, Colombo CS, Illfelder MA, Skaggs RE. Bronchial and gastrointestinal cryptosporidiosis in AIDS. J Am Osteopath Assoc. 1989; 89(2):195-7.
10. Evering T, Weiss LM. The immunology of parasite infections in immunocompromised hosts. Parasite Immunol. 2006; 28(11):549-65.
11. Gupta S, Narang S, Nunavath V, Singh S. Chronic diarrhoea in HIV patients: prevalence of coccidian parasites. Indian J Med Microbiol. 2008; 26(2):172-5.
12. Wiwanitkit V. Intestinal parasitic infections in Thai HIV-infected patients with different immunity status. BMC Gastroenterol. 2001; 1: 3.
13. Adeyemo FE, Singh G, Reddy P, Stenström TA. Methods for the detection of Cryptosporidium and Giardia: From microscopy to nucleic acid-based tools in clinical and environmental regimes. Acta Trop. 2018; 184:15-28.
14. Kumar H, Singh VB, Meena BL, et al. Pulmonary cryptosporidiosis in an immunocompetent host treated successfully with nitazoxanide. Lung India. 2016; 33(1):69-71.
15. Gilbert IH, Vinayak S, Striepen B, et al. Safe and effective treatments are needed for cryptosporidiosis, a truly neglected tropical disease. BMJ Glob Health. 2023; 8(8): e012540.
| Files | ||
| Issue | Vol 20 No 1 (2025) | |
| Section | Case Report(s) | |
| Keywords | ||
| HIV Cryptosporidium Pulmonary cryptosporidi-osis Opportunistic infection | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Rashidifar S, Gharavi M, Harzandi N, Momeni Z, Hasan Nezhad M. Pulmonary Cryptosporidiosis in HIV Infected Patients at Imam Khomeini Complex Hospital in Tehran, Iran: A Case Series. Iran J Parasitol. 2025;20(1):148-152.
