Skip to main content
Log in

Low prevalence of intestinal cryptosporidiosis among immunocompetent and immunocompromised patients with and without diarrhoea in Southern Germany

Niedrige Prävalenz intestinaler Kryptosporidiose bei immunkompetenten und abwehrgeschwächten Patienten mit und ohne Diarrhoe in Süddeutschland

  • Originalia
  • Published:
Infection Aims and scope Submit manuscript

Summary

1160 stool specimens, from 160 severely immunocompromised patients, from 70 adults and 180 children with acute diarrhoea and from 60 controls without diarrhoea and without evidence of immunocompromising underlying disorders, were examined for Cryptosporidium excretion. Only two children (1.1%) (one with previous contact to a straying cat and to lambs, the other without known risk) had documented intestinal cryptosporidiosis, whereas none of the symptomatic adults, immunocompromised patients or controls were found to be positive for Cryptosporidium fecal excretion. Other potential protozoal enteric pathogens among immunocompromised patients were only found in seven of 25 patients with HIV infection. We conclude that sporadic intestinal cryptosporidiosis in Southern Germany is a rare disease in humans even of younger age, but should be included in the differential diagnosis of diarrhoea in immunocompetent and immunocompromised patients.

Zusammenfassung

1160 Stuhlproben von 160 abwehrgeschwächten Patienten, von 70 Erwachsenen und 180 Kindern mit akuter Diarrhoe und von 60 erwachsenen Kontrollpersonen ohne Diarrhoe und Immundefekt wurden auf Kryptosporidien untersucht. Nur zwei aus der Gruppe symptomatischer Kinder ohne Immundefekt (1,1%) hatten einen positiven Befund (ein Kind mit Kontakt zu einer streunenden Katze und zu Lämmern, das andere ohne bekannte Exposition), dagegen keiner der Erwachsenen mit und ohne Diarrhoe und keiner der abwehrgeschwächten Patienten. Andere, potentiell pathogene Protozoen bei Immundefizienten wurden lediglich bei sieben von 25 HIV-Infizierten nachgewiesen. Wir schließen daraus, daß die Kryptosporidiose im süddeutschen Raum auch bei Kindern eine sehr seltene sporadische Erkrankung ist. Sie sollte jedoch in der Differentialdiagnose der akuten Diarrhoe berücksichtigt werden.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Literature

  1. Tzipori, S. Cryptosporidiosis in animals and humans. Microbiol. Rev. 47 (1983) 84–96.

    Google Scholar 

  2. Current, W. L., Reese, N. C., Ernst, J. V., Bailey, W. S., Heymann, M. B., Weinstein, W. M. Human cryptosporidiosis in immunocompetent and immunodeficient persons: studies of an outbreak and experimental transmission. N. Engl. J. Med. 308 (1983) 1252–1257.

    Google Scholar 

  3. Dworkin, B., Wormser, G. P., Rosenthal, W. S., Heier, S. K., Braunstein, M. R., Weiss, L., Jankoski, R., Levy, D., Weiselberg, S. Gastrointestinal manifestations of the acquired immunodeficiency syndrome: a review of 22 cases. Am. J. Gastroenterol. 80 (1985) 774–778.

    Google Scholar 

  4. Angus, K. W. Cryptosporidiosis in man, domestic animals and birds: a review. J. R. Soc. Med. 76 (1983) 62–70.

    Google Scholar 

  5. Jokipii, L., Pohjola, S., Jokipii, A. M. M. Cryptosporidium: a frequent finding in patients with gastrointestinal symptoms. Lancet II (1983) 358–361.

    Google Scholar 

  6. Casemore, D. P., Jackson, B. Sporadic cryptosporidiosis in children. Lancet II (1983) 679.

    Google Scholar 

  7. Hunt, D. A., Shannon, R., Palmer, S. R., Jephcott, A. E. Cryptosporidiosis in an urban community. Br. Med. J. 289 (1984) 814–816.

    Google Scholar 

  8. Wolfson, J. S., Richter, J. M., Waldron, M. A., Weber, D. J., McCarthy, D. M., Hopkins, C. C. Cryptosporidiosis in immunocompetent patients. N. Engl. J. Med. 312 (1985) 1278–1282.

    Google Scholar 

  9. Tzipori, S., Smith, M., Birch, C., Barnes, G., Bishop, R. Cryptosporidiosis in hospital patients with gastroenteritis. Am. J. Trop. Med. Hyg. 32 (1983) 931–934.

    Google Scholar 

  10. White, W. L., Picklo, J. Human cryptosporidiosis. N. Engl. J. Med. 309 (1983) 1325.

    Google Scholar 

  11. Isaacs, D., Hunt, G. H., Philipps, A. D., Price, E. H., Rafaat, F., Walker-Smith, J. A. Cryptosporidiosis in immunocompetent children. J. Clin. Pathol. 38 (1985) 76–81.

    Google Scholar 

  12. Burchard, G. D. Klinische Bedeutung, Epidemiologie und Laboratoriumsdiagnostik enteraler Infektionen mit Kryptosporidien. Immun. Infekt. 14 (1986) 51–57.

    Google Scholar 

  13. Jokipii, L., Jokipii, A. M. M. Timing of symptoms and oocyst excretion in human cryptosporidiosis. N. Engl. J. Med. 315 (1986) 1643–1647.

    Google Scholar 

  14. Heine, J. Eine einfache Nachweismethode für Kryptosporidien im Kot. Zentralbl. Veterinärmed. B. 29 (1982) 324–327.

    Google Scholar 

  15. Günther, H. Kryptosporidien beim Kalb. Bedeutung, Nachweis, Bekämpfung. Monatsh. Veterinärmed. 38 (1983) 653–655.

    Google Scholar 

  16. Henriksen, S. A., Pohlenz, J. F. L. Staining of cryptosporidia by a modified Ziehl-Neelsen technique. Acta Vet. Scand. 22 (1981) 594–596.

    Google Scholar 

  17. Ma. P., Soave, R. Three-step stool examination for cryptosporidiosis in 10 homosexual men with protracted watery diarrhoea. J. Infect. Dis. 147 (1983) 824–828.

    Google Scholar 

  18. Soave, R., Danner, R. L., Honig, C. L., Ma, P., Hart, C. C., Nash, T., Roberts, R. B. Cryptosporidiosis in homosexual men. Ann. Intern. Med. 100 (1984) 504–511.

    Google Scholar 

  19. Centers for Disease Control Update: treatment of cryptosporidiosis in patients with acquired immunodeficiency syndrome (AIDS). MMWR 33 (1984) 117–119.

    Google Scholar 

  20. Baxby, D., Bennett, M., Blundell, N., Hart, C. Cryptosporidium and cats. CDR 40/84 (1984) 3–4.

    Google Scholar 

  21. Miller, R. A., Holmberg, R. E., Clausen, C. R. Life-threatening diarrhoea caused by cryptosporidium in a child undergoing therapy for acute lymphocytic leukemia. J. Pediatr. 103 (1983) 256–259.

    Google Scholar 

  22. Public Health Laboratory Service Cryptosporidium reports 1983. Protozoa weeks 84/05-08. CDR 8/84 (1984) 4.

    Google Scholar 

  23. Portnoy, D., Whiteside, M. E., Buckley, E., MacLeod, C. L. Treatment of intestinal cryptosporidiosis with spiramycin. Ann. Intern. Med. 101 (1984) 202–204.

    Google Scholar 

  24. Weisburger, W. R., Hutcheon, D. F., Yardley, J. H., Roche, J. C., Hillis, W. D., Charach, P. Cryptosporidiosis in an immunosuppressed renal-transplant recipient. Am. J. Clin. Pathol. 72 (1979) 473–478.

    Google Scholar 

  25. Lasser, K. H., Lewin, K. J., Ryning, E. W. Cryptosporidial enteritis in a patient with congenital hypogammaglobulinemia. Hum. Pathol. 10 (1979) 234–240.

    Google Scholar 

  26. Kocoshis, S. A., Cibull, M. L., Davis, T. E., Hinton, J. T., Seip, M., Banwell, J. G. Intestinal and pulmonary cryptosporidiosis in an infant with severe combined immune deficiency. J. Pediatr. Gastroenterol. Nutr. 3 (1984) 149–157.

    Google Scholar 

  27. Baxby, D., Hart, D. A., Taylor, E. Human cryptosporidiosis: a possible cause of hospital cross infection. Br. Med. J. 287 (1983) 1760–1761.

    Google Scholar 

  28. Centers for Disease Control Cryptosporidiosis among children attending day-care centers: Georgia, Pennsylvania, Michigan, California, New Mexico. MMWR 33 (1984) 599–601.

    Google Scholar 

  29. McNabb, S. J. N., Hensel, D. M., Welch, D. F., Heubel, H., McKnee, G. L., Istre, G. R. Comparison of sedimentation and flotation techniques for identification of Cryptosporidium sp. oocysts in a large outbreak of human diarrhoea. J. Clin. Microbiol. 22 (1985) 587–589.

    Google Scholar 

  30. Zar, F., Geissler, J., Brown, V. A. Asymptomatic carriage of Cryptosporidium in the stool of a patient with acquired immunodeficiency syndrome. J. Infect. Dis. 151 (1985) 195.

    Google Scholar 

  31. Scaglia, M., Senaldi, G., Di Perri, G., Minoli, L. Unusual low-grade cryptosporidial enteritis in AIDS: a case report. Infection 14 (1986) 87–88.

    Google Scholar 

  32. Henkel, G. Kryptosporidiose des Menschen. Münchn. Med. Wochenschr. 125 (1983) 1099–1102.

    Google Scholar 

  33. Holley, H. P., Dover, C. Cryptosporidium: a common cause of parasitic diarrhoea in otherwise healthy individuals. J. Infect. Dis. 153 (1986) 365–368.

    Google Scholar 

  34. Heidl, M., Hering, L., Scholz, H. Kryptosporidiose bei Kindern. Infection 14 (1986) 173–176.

    Google Scholar 

  35. Garcia, L. S., Bruckner, D. A., Brewer, T. C., Shimizu, R. Y. Techniques for the recovery and identification of Cryptosporidium oocysts from stool specimens. J. Clin. Microbiol. 18 (1983) 185–190.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kern, W., Mayer, S., Kreuzer, P. et al. Low prevalence of intestinal cryptosporidiosis among immunocompetent and immunocompromised patients with and without diarrhoea in Southern Germany. Infection 15, 440–443 (1987). https://doi.org/10.1007/BF01647226

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01647226

Keywords

Navigation