Unusual enteric protozoal pathogens are being encountered
more frequently in clinical practice specially after
the identification of the acquired immune deficiency syndrome
(AIDS). Meanwhile renal transplant recipients are
at greater risk of developing opportunistic infections due
to their immunosuppressed state. In this multi-centre study
three stool specimens from 104 renal transplant recipients
were stained with: Modified Ziehl-Neelsen, Auramine
Rhodamine. Kinoyoun Acid Fast, Giemsa and Gomori
stains and then examined microscopically for the identification
of the characteristic oocysts of Cryptosporidia, Cyclosporidia,
lsospora and Microspora. The studied group
included 52 subjects with gastro-intestinal symptoms and
52 asymptomatic subjects serving as a control group. Our
results showed that Cryptosporidia oocysts were seen in
29 subjects (55.8%) in the symptomatic group and in 14
subjects (25.9%) in the asymptomatic group. All infected
cases had cryptosporidia oocyst in their stool: 88.4% as a
single infection, 9.3% mixed infection with isosporiosis,
2.3% mixed infection with cyclosporiosis, while no infection
with microsporiosis was detected. The rate of enteric
coccidiosis correlated positively with the duration of the
kidney transplant but not with other variables including
the immuno-suppressive therapy regimen, the total dose of
steroids and the number of rejection episodes. Enteric coccidiosis
is an important cause of gastro-intestinal symptoms
in renal transplant recipients and special staining procedures
for the identification of these protozoal pathogens
in stool specimens should be requested in such patients
presenting with diarrhea and/or abdominal pain. |
