Intensity of infection in AIDS-associated cryptosporidiosis.

A fluorescent monoclonal anti-Cryptosporidium antibody was used to count the oocysts in stools of 12 AIDS patients with chronic cryptosporidiosis. Oocyst excretion was present throughout the day in all 12 patients. Stool-to-stool variation in oocyst concentration was within one order of magnitude. Small variations were also found in daily mean oocyst concentration and total daily oocyst excretion in 3 patients who had multiple 24-h stool collections. However, there was a large patient-to-patient variation in mean oocyst concentration (from < 5.0 x 10(3) to 9.2 x 10(5) oocysts/mL) and 24-h total oocyst excretion (from < 6.0 x 10(6) to 1.2 x 10(9) oocysts/day). There was a significant correlation between oocyst excretion and numbers of Cryptosporidium organisms seen on small bowel biopsy. Oocyst excretion was reduced in 4 patients treated with paromomycin, but diarrhea improved only in the 2 patients with high initial oocyst excretion.

[1]  A. Vuorio,et al.  Cryptosporidium in asymptomatic children. , 1991, Reviews of infectious diseases.

[2]  D. Kotler,et al.  Enteropathy associated with the acquired immunodeficiency syndrome. , 1984, Annals of internal medicine.

[3]  R. Miller,et al.  Experimental cryptosporidiosis in a primate model. , 1990, The Journal of infectious diseases.

[4]  T. Flanigan,et al.  Paromomycin inhibits Cryptosporidium infection of a human enterocyte cell line. , 1992, The Journal of infectious diseases.

[5]  M. Heyman,et al.  Human cryptosporidiosis in immunocompetent and immunodeficient persons. Studies of an outbreak and experimental transmission. , 1983, The New England journal of medicine.

[6]  N. Sewankambo,et al.  Enteropathic AIDS in Uganda. An endoscopic, histological and microbiological study. , 1987, AIDS.

[7]  J. Pape,et al.  Clinical manifestations and therapy of Isospora belli infection in patients with the acquired immunodeficiency syndrome. , 1986, The New England journal of medicine.

[8]  P. Geiseler,et al.  Asymptomatic carriage of cryptosporidium in the stool of a patient with acquired immunodeficiency syndrome. , 1985, The Journal of infectious diseases.

[9]  C. Lightdale,et al.  Malabsorption and mucosal abnormalities of the small intestine in the acquired immunodeficiency syndrome. , 1985, Annals of internal medicine.

[10]  R. Danner,et al.  Cryptosporidiosis in homosexual men. , 1984, Annals of internal medicine.

[11]  A. Curry,et al.  Cryptosporidium species a "new" human pathogen. , 1985, Journal of clinical pathology.

[12]  E. Janoff,et al.  Cryptosporidial carriage without symptoms in the acquired immunodeficiency syndrome (AIDS) , 1990, Annals of internal medicine.

[13]  C. Sterling,et al.  Effects of immune colostrum and orally administered antisporozoite monoclonal antibodies on the outcome of Cryptosporidium parvum infections in neonatal mice , 1989, Infection and immunity.

[14]  K. Kotloff,et al.  Cryptosporidium infection in acquired immunodeficiency syndrome: not always a poor prognosis. , 1991, Journal of clinical gastroenterology.

[15]  R. Jankowski,et al.  Gastrointestinal manifestations of the acquired immunodeficiency syndrome: a review of 22 cases. , 1985, The American journal of gastroenterology.

[16]  G. Senaldi,et al.  Unusual low-grade cryptosporidial enteritis in AIDS: A case report. , 1986, Infection.

[17]  S. Pitlik,et al.  Human cryptosporidiosis: spectrum of disease. Report of six cases and review of the literature. , 1983, Archives of internal medicine.

[18]  T. Seemayer,et al.  ACQUIRED IMMUNODEFICIENCY SYNDROME WITH SEVERE GASTROINTESTINAL MANIFESTATIONS IN HAITI , 1983, The Lancet.

[19]  J. Rehg.  Activity of azithromycin against cryptosporidia in immunosuppressed rats. , 1991, The Journal of infectious diseases.

[20]  M. Horne,et al.  Vitamin B12 malabsorption in patients with acquired immunodeficiency syndrome. , 1989, Archives of internal medicine.

[21]  G. Guyatt,et al.  Treatment of cryptosporidiosis with spiramycin in AIDS. An "N of 1" trial. , 1987, Journal of clinical gastroenterology.

[22]  C. Sterling,et al.  Comparison of conventional staining methods and monoclonal antibody-based methods for Cryptosporidium oocyst detection , 1989, Journal of clinical microbiology.

[23]  J. Sullivan,et al.  Threshold of detection of Cryptosporidium oocysts in human stool specimens: evidence for low sensitivity of current diagnostic methods , 1991, Journal of clinical microbiology.

[24]  T. J. Breen,et al.  Biostatistical Analysis (2nd ed.). , 1986 .

[25]  A. Fauci,et al.  Intestinal infections in patients with the acquired immunodeficiency syndrome (AIDS). Etiology and response to therapy. , 1988, Annals of internal medicine.

[26]  R. Yolken,et al.  Prevalence of enteric pathogens in homosexual men with and without acquired immunodeficiency syndrome. , 1988, Gastroenterology.

[27]  A. Sonnenberg,et al.  Efficient management of diarrhea in the acquired immunodeficiency syndrome (AIDS). A medical decision analysis. , 1990, Annals of internal medicine.

[28]  K. Clezy,et al.  Paromomycin for the treatment of cryptosporidial diarrhoea in AIDS patients. , 1991, AIDS.

[29]  D. Blewett,et al.  Cryptosporidiosis. Proceedings of the first international workshop. Moredun Research Institute, Edinburgh, 7-8 September 1988. , 1989 .

[30]  P. Echeverria,et al.  WHEN DOES CRYPTOSPORIDIUM CAUSE DIARRHOEA? , 1986, The Lancet.

[31]  L. Perryman,et al.  Infectivity and neutralization of Cryptosporidium parvum sporozoites , 1987, Infection and immunity.