Cryptosporidiosis in immunocompromised patients in the Islamic Republic of Iran.

BACKGROUND AND PURPOSE Cryptosporidiosis is a parasitic zoonosis, which is prevalent all over the world. The manifestation of the disease is either self-limiting acute diarrhea in immunocompetent individuals, or potentially fatal chronic diarrhea in immunocompromised patients. METHODS In this study, which was conducted in Tehran, 214 patients from ten health centers were investigated. Stool samples were collected, fixed and examined by three methods: acid-fast staining, auramin phenol fluorescence and direct fluorescence using monoclonal antibody. RESULTS Overall, 1.4% of all patients and 6.3% of diarrheal patients were infected by Cryptosporidium. The results revealed three cases of cryptosporidiosis, including two cases of acquired immunodeficiency syndrome (AIDS) and one of acute myeloid leukemia (AML). The prevalence of infection in subjects with AIDS or AML who were suffering from diarrhea was 33.4% and 11.1%, respectively. The duration of disease in infected patients lasted for weeks, and was terminated by death in two AIDS patients. In the patient with AML, diarrhea lasted for 18 days, and stopped after discontinuation of immunosuppressive therapy. CONCLUSIONS Immunosuppressed people are at a significant risk of severe or even fatal Cryptosporidium infections.