A Study of the Newly Recognized Agents as Pathogens Causing Diarrhoea in Immunocompromised Children.
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21) immunocompromised children having different types of malignancies (leukemia, lymphoma, Hodgkin's disease and ueuroblastoma) together with (20) control children were subjected to this study. Both groups of children complained of diarrhoea. Bacteriological and Parasitological examination of their stool specimens was done. Bacteriological examination revealed only one positive case of Aeromonas (4.8%) in immunocomproised groupwhile in immunocomptent children this organism could not be isolated. Parasitological examination revealed 8 positive cases (38%) of cryptosporida in immunocompromised cases and 4 cases (20%) in the immunocomptent children. Strongyloides stercoralis infection was found in 1 cases (4.8%) tit malignancy group while it could not be detected in faecal specimens of immunocomptent children. The compromised host has one or more defects in the normal defense mechanisms that protect individual from infectious agents, predisposing him to an increased risk of severe infection. Malignancy is associated with multiple defects in host defense and in addition cancer chemotherapy itself contributes to more defects in local (central venous catheter placement, surgeory, mucositis and venipmcture) and systemic (neutropertia, lymphopenia, T and B lymphocyte function) host defense. It is agreed that neutropenia and attenuated cell-mediated immunity are the two greatest risk factors for infection in patients with malignancy (Behraman and vaughan 1992). In this way, pathogenic or potentially pathogenic infectious agents are invited easily to the compromised host. Gastrointestinal infection continues to be a major complication in inununocompromised children and the majority of these infections arise from endogenous microbial flora or aquired from hosital environment (Brady, 1989). Recent reports have described detection of cyanobcteria (blue- green algae)- like bodies MMWR, 1991) and a fastidious gram-negative coccobacillus in stool culture of immunocompromised host by selective media (Blum et al, 1992). Inununocompromised patients may suffer from dissemination of reactivated latent infections, invading pathogens and opportunistic. It is those infections with parasites against which immunity is preclominantely T-cell mediated that are likely to be more severe. Among parasites that pose a major hazard in immunocompromised patients include Cryptosporidium