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Background: Cystoisospora spp. is considered a potential pathogen to cause diarrhoea in cats, and the disease occurs clinically, especially in young, weak and immunocompromised cats. The present study aimed to evaluate the clinical utility and diagnostic roles of neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte (MLR) ratios in diarrheal cats infected with Cystoisospora spp. Materials, Methods & Results: Twenty-five cats with diarrhea due to infection caused by Cystoisospora spp. and 15 healthy cats were included in this study. The anamnesis, clinical and laboratory findings of all cats were recorded. A clinical severity score was generated for diarrheal cats, which included activity, appetite, presence of vomit, and faecal consistency. Also, cats infected with Cystoisospora spp. were classified as systemic inflammatory response syndrome (SIRS) positive (+) and SIRS (-) group according to the presence of at least 3 of the SIRS criteria. The Cystoisospora spp. oocysts were diagnosed by direct smear and simple faecal flotation. Cats found positive for other parasitic and protozoal agents by faeces examination were excluded from the study. Complete blood counts (CBC) were performed with an automated blood cell counter for all cats. Blood smears were prepared (with May-Grunwald Giemsa) from samples, and the CBC results were confirmed microscopically (obj.100x). White blood cell (WBC), neutrophil, lymphocyte and monocyte counts were recorded directly from the CBC. The neutrophil-to-lymphocyte ratio was calculated as the ratio of the absolute neutrophil count to the absolute lymphocyte count. The monocyte-to-lymphocyte was calculated as the absolute monocyte count ratio to the absolute lymphocyte count. White blood cell (P = 0.015), neutrophil (P = 0.001), monocyte (P = 0.033), NLR (P = 0.000) and MLR (P = 0.042) of diarrheal cats infected with Cystoisospora spp. were significantly higher than in the healthy group. There was no significant difference between groups in the lymphocyte counts (P > 0.05). SIRS (+) group had statistically significantly higher WBC (P = 0.014), neutrophil counts (P = 0.000), NLR (P = 0.000) and MLR (P = 0.037) than the healthy group. Also, neutrophil counts and NLR of the SIRS (+) group were statistically significantly higher than the SIRS (-) group (P = 0.032; P = 0.001, respectively). However, there was no significant difference SIRS (+), SIRS (-), and healthy groups regarding lymphocyte and monocyte counts (P > 0.05). The clinical severity of the disease positively correlated with NLR and MLR. Also, the best cut-off value of NLR to predict SIRS was > 1.67, with 92.86% sensitivity and 84.62% specificity. MLR was not a useful predictor for SIRS. Discussion: NLR and MLR are parameters derived from complete blood count. In recent years, they have been used in human and veterinary medicine as a biomarker in the diagnosis, prognosis and treatment follow-up of various diseases and provide valuable information about inflammation. In cats, there are limited studies on NLR, and to our knowledge, there are no studies on MLR. The current study suggests that NLR and MLR may be used to determine the severity of the inflammatory condition in diarrheal cats infected with Cystoisospora spp., and NLR is a useful marker for predicting SIRS status in these cats. In addition, this study also will contribute to larger-scale studies in the future.

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Cystoisospora belli causes chronic diarrhoea, acalculous cholecystitis, cholangiopathy and disseminated cystoisosporosis in patients with AIDS. Clinical manifestations and histological stages during C. belli infection in a patient with AIDS and liver disease were described. It was possible to identify sporozoite-like structures in the villus epithelium of the duodenum, close to the vascularization that underlies the basal membrane and unizoite tissue cysts near to the vascularization in the lamina propria. Unizoite tissue cysts were found inside of sinusoids in the liver communicating with the central vein and with a bile canaliculus and portal spaces. Based on these findings a hypothesis on C. belli life cycle could consider that the route of migration of unizoite tissue cysts up the liver is via the portal blood. The unizoite tissue cysts located in hepatic portal vein could migrated via sinusoid to central vein and general circulation through the venous system. The unizoite tissue cysts could also return via bile canaliculus to bile duct to portal triad. This hypothesis allows to understand the presence of unizoite stages in blood, the pathway by which the bile ducts become infected and unizoites in the liver being able to behave like hypnozoites that favour relapses and treatment failures.

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Neotropical wild felids (NWF) are obligate carnivore species present in Central and South America, and some are considered endangered due to constantly decreasing populations. NWF can become infected by a wide range of protozoan and metazoan parasites, some of them affecting their health conditions and others having anthropozoonotic relevance. Parasitological studies on NWF are still very scarce, and most data originated from dead or captive animals. On this account, the current study aimed to characterize gastrointestinal parasites of free-ranging jaguars (Panthera onca), pumas (Puma concolor), ocelots (Leopardus pardalis), and jaguarundis (Herpailurus yagouaroundi), i.e., four out of six NWF species endemic to Colombia. Fecal samples from jaguars (n = 10) and ocelots (n = 4) were collected between 2012 and 2017 as part of the Jaguar Corridor Initiative from six geographic locations in Colombia. In addition, cestode specimens were obtained during puma and jaguarundi necropsies. Scat samples were processed by standardized sodium acetate-acetic acid-formalin (SAF), sedimentation, and flotation techniques and by carbol fuchsin-stained fecal smears. Morphological evaluation of feces showed the presence of one cestode (Spirometra sp.), a nematode (Toxocara cati), an acanthocephalan (Oncicola sp.), and one cyst-forming coccidian (Cystoisospora-like oocysts). Feces oocysts were submitted to a Toxoplasma gondii-specific PCR for species identification, but no product was amplified. The cestodes isolated from a puma and jaguarundi were molecularly characterized by sequencing cytochrome c oxidase subunit I, identifying them as Taenia omissa and as a T. omissa sister lineage, respectively. These results collectively demonstrate the potential role of NWF as natural reservoir hosts for neglected zoonotic parasites (e.g., Spirometra sp., T. cati) and highlight their possible role in parasite transmission to human communities. Due to public health concerns, the occurrence of these parasites should be monitored in the future for appropriate zoonotic management practices in conservation strategies and wild felid health management programs.

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Intestinal coccidia have been classified as protozoa of the Apicomplex phylum, with the presence of an intracellular behavior and adaptation to the habit of the intestinal mucosa, related to several parasites that can cause enteric infections in humans, generating especially complications in immunocompetent patients and opportunistic infections in immunosuppressed patients. Alterations such as HIV/AIDS, cancer and immunosuppression. Cryptosporidium spp., Cyclospora cayetanensis and Cystoisospora belli are frequently found in the species. Multiple cases have been reported in which their parasitic organisms are associated with varying degrees of infections in the host, generally characterized by gastrointestinal clinical manifestations that can be observed with diarrhea, vomiting, abdominal cramps, malaise and severe dehydration. Therefore, in this review a specific study of epidemiology has been conducted in relation to its distribution throughout the world and in Colombia, especially, global and national reports about the association of coccidia informed with HIV/AIDS. Proposed revision considering the needs of a consolidated study in parasitology, establishing clarifications from the transmission mechanisms, global and national epidemiological situation, impact at a clinical level related to immunocompetent and immunocompromised individuals, as well as a focus on public health in institutional government policies and scientific information based on the characterization of coccidia in the tropical region and Colombia.

Los coccidios intestinales se han clasificado como protozoos del Apicomplexa phylum, con presencia de un comportamiento intracelular y adaptación al hábito de la mucosa intestinal, relacionado con varios parásitos que pueden causar infecciones entéricas en los humanos, generando especialmente complicaciones en pacientes inmunocompetentes e infecciones oportunistas en pacientes inmunodeprimidos. Alteraciones como el VIH/SIDA, cáncer e inmunosupresión con tratamientos farmacológicos. En las especies que se encuentran frecuentemente se encuentran Cryptosporidium spp., Cyclospora cayetanensis y Cystoisospora belli. Se han reportado múltiples casos en los que sus organismos parásitos se asocian a diversos grados de infecciones en el huésped, generalmente caracterizadas por manifestaciones clínicas gastrointestinales que pueden observarse con diarrea, vómitos, calambres abdominales, malestar general y deshidratación severa. Por lo tanto, en esta revisión se ha realizado un estudio específico de epidemiología con relación a su distribución en todo el mundo y en Colombia, especialmente, reportes a nivel global y nacional a cerca de la asociación de coccidios informados con el VIH/SIDA. Revisión propuesta con el objetivo de considerar las necesidades de un estudio consolidado a nivel del campo de la parasitología, evidenciando literatura actualizada, estableciendo información de los mecanismos de transmisión, situación epidemiológica global y nacional, impacto a nivel clínico relacionadas con individuos inmunocompetentes e inmunocomprometidos, así como un enfoque en salud pública en políticas gubernamentales institucionales y la información científica basada en la caracterización de coccidias en la región tropical y principalmente en Colombia.

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Cystoisospora felis (Wenyon 1923) was identified in a 3-month-old, captive jaguar (Panthera onca) presenting with signs of gastrointestinal distress. The cub was fed beef, chicken, and commercial diet. Examination of fresh feces detected large (47.8 µm × 35 µm) unsporulated oocysts. Sporulated oocysts contained 2 sporocysts, each with 4 sporozoites. Oocyst morphometrics agreed with published features of C. felis described from domestic felines. Partial mitochondrial cytochrome c oxidase subunit I (mtCOI) gene was PCR-amplified and sequenced; the resulting sequence showed 100% identity to a C. felis isolate from a domestic cat. This is the first molecularly confirmed report of C. felis infecting and producing clinically evident, enteric disease in a jaguar cub.

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Abstract There is great diversity in swine coccidia, which are responsible for causing intestinal disorders ranging from sporadic diarrhea to severe cases of hemorrhagic enteritis. Thus, determining the species of coccidia that affect the animals of a region and associating them with the characteristics of the farms become extremely important. The objective of this study was to determine the prevalence of coccidia parasites in pigs reared in a family farming production system in the Semiarid Region of the State of Paraíba, Northeast Brazil. Fecal samples for analysis were collected from 187 pigs on 51 farms. For morphological analysis, 1,590 sporulated oocysts were used. The prevalence of oocysts in fecal samples was 56.6% (106/187). The most prevalent species were Eimeria suis (21.9%), followed by Eimeria neodebliecki (16.6%), Eimeria perminuta (14.9%), Eimeria polita (12.8%), Eimeria debliecki (10.6%), Eimeria porci (10.1%), Cystoisospora suis (3.7%), Eimeria scabra (1.6%) and Eimeria cerdonis (0.5%). It can be concluded that pigs from the Semiarid Region of the State of Paraíba were parasitized by a diversity of coccidia species, mainly of the genus Eimeria, and predominantly presented with mixed infections occurring in the subclinical form.

Resumo Há uma grande diversidade de coccídios que parasitam os suínos, sendo responsáveis por causarem desordens intestinais que variam de diarreias esporádicas a casos severos de enterites hemorrágicas. Assim, determinar as espécies de coccídios que afetam os animais de uma região e associá-los com as características das fazendas torna-se extremamente importante. Objetivou-se determinar a prevalência de coccídios em suínos criados em sistema de produção de agricultura familiar no Semiárido da Paraíba, Nordeste do Brasil. Foram analisados oocistos íntegros e esporulados no período de março a setembro de 2018, oriundos de 187 suínos, em 51 propriedades. Para a análise morfológica foram utilizados 1.590 oocistos esporulados. A prevalência de oocistos de coccídios foi detectada em 56,6% (106/187) das amostras analisadas. A espécie mais prevalente foi Eimeria suis (21,9%), seguida por Eimeria neodebliecki (16,6%), Eimeria perminuta (14,9%), Eimeria polita (12,8%), Eimeria debliecki (10,6%), Eimeria porci (10,1%), Cystoisospora suis (3,7%), Eimeria scabra (1,6%) e Eimeria cerdonis (0,5%). Concluiu-se que os suínos do Semiárido da Paraíba estavam parasitados por uma alta diversidade de espécies de coccídios, principalmente do gênero Eimeria, apresentando predominantemente infeções mistas, que ocorrem sob a forma subclínica.

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There is great diversity in swine coccidia, which are responsible for causing intestinal disorders ranging from sporadic diarrhea to severe cases of hemorrhagic enteritis. Thus, determining the species of coccidia that affect the animals of a region and associating them with the characteristics of the farms become extremely important. The objective of this study was to determine the prevalence of coccidia parasites in pigs reared in a family farming production system in the Semiarid Region of the State of Paraíba, Northeast Brazil. Fecal samples for analysis were collected from 187 pigs on 51 farms. For morphological analysis, 1,590 sporulated oocysts were used. The prevalence of oocysts in fecal samples was 56.6% (106/187). The most prevalent species were Eimeria suis (21.9%), followed by Eimeria neodebliecki (16.6%), Eimeria perminuta (14.9%), Eimeria polita (12.8%), Eimeria debliecki (10.6%), Eimeria porci (10.1%), Cystoisospora suis (3.7%), Eimeria scabra (1.6%) and Eimeria cerdonis (0.5%). It can be concluded that pigs from the Semiarid Region of the State of Paraíba were parasitized by a diversity of coccidia species, mainly of the genus Eimeria, and predominantly presented with mixed infections occurring in the subclinical form.(AU)

Há uma grande diversidade de coccídios que parasitam os suínos, sendo responsáveis por causarem desordens intestinais que variam de diarreias esporádicas a casos severos de enterites hemorrágicas. Assim, determinar as espécies de coccídios que afetam os animais de uma região e associá-los com as características das fazendas torna-se extremamente importante. Objetivou-se determinar a prevalência de coccídios em suínos criados em sistema de produção de agricultura familiar no Semiárido da Paraíba, Nordeste do Brasil. Foram analisados oocistos íntegros e esporulados no período de março a setembro de 2018, oriundos de 187 suínos, em 51 propriedades. Para a análise morfológica foram utilizados 1.590 oocistos esporulados. A prevalência de oocistos de coccídios foi detectada em 56,6% (106/187) das amostras analisadas. A espécie mais prevalente foi Eimeria suis (21,9%), seguida por Eimeria neodebliecki (16,6%), Eimeria perminuta (14,9%), Eimeria polita (12,8%), Eimeria debliecki (10,6%), Eimeria porci (10,1%), Cystoisospora suis (3,7%), Eimeria scabra (1,6%) e Eimeria cerdonis (0,5%). Concluiu-se que os suínos do Semiárido da Paraíba estavam parasitados por uma alta diversidade de espécies de coccídios, principalmente do gênero Eimeria, apresentando predominantemente infeções mistas, que ocorrem sob a forma subclínica.(AU)

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Acute diarrhea in young dogs is among the main complaints described by tutors in veterinary services. Complications related to water and electrolyte imbalances due to intestinal alterations can compromise homeostasis in these pups, mainly due to dehydration. Consequently, they do not present a satisfactory clinical response and are exposed to the risk of early death. Among the different types of diarrhea, the infectious diarrhea due to viruses, bacteria, and parasites are particularly significant. Coccidia of the genus Isospora (Cystoisospora spp.) is an important intestinal pathogen that causes severe clinical manifestations in puppies. Since high parasitic loads render these puppies highly susceptible to opportunistic infections, coccidia infection may cause impaired corporal and cognitive development and even lead to death. Studies regarding this issue, particularly concerning clinical knowledge in neonatology, are scarce in veterinary medicine. Thus, in this study, we intend to discuss the enteric alterations and the most commonly used current diagnostic techniques, as well as to analyze effective therapeutic and prophylactic proposals.

As diarreias agudas em cães jovens estão entre as principais queixas descritas pelos tutores nos serviços veterinários. As complicações relacionadas aos desequilíbrios hídrico e eletrolítico decorrentes das alterações intestinais comprometem a homeostase destes filhotes, principalmente devido a desidratação, não apresentam resposta clínica satisfatória e ficam expostos ao risco de morte precoce. Dentre os diferentes tipos de diarreia, sobressaem as de origem infecciosa. Os agentes podem ser vírus, bactérias, fungos e parasitos. Entre estes últimos agentes, os coccídios do Gênero Isospora (Cystoisospora spp.) se destacam como patógenos intestinais que ocasionam manifestações clínicas graves em filhotes, pois elevadas cargas parasitárias propiciam condição de maior susceptibilidade à infecções oportunistas, podendo também prejudicar o desenvolvimento corporal e cognitivo e/ou até mesmo levar a morte do cão. Diante de tal temática, na medicina veterinária os estudos são escassos, principalmente quanto ao conhecimento clínico em neonatologia de tal modo tencionamos discutir a respeito das alterações entéricas, métodos de diagnóstico mais utilizados e atuais, bem como analisar as propostas terapêuticas e profiláticas efetivas.

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Cystoisospora felis is a coccidian parasite commonly found in feces of domestic cats. Infection in cats occurs by ingestion of sporulated oocysts or consumption of rodents infected by the parasite. Scarce information is available about extraintestinal stages of C. felis in naturally infected intermediate hosts, as well as in cell culture. The aim of the current work was to investigate the development of C. felis in Vero cells (African green monkey kidney) and MDCK cells (Madin-Darby canine kidney). Cell monolayers were inoculated with mechanically released sporozoites of C. felis, and parasite growth was daily examined using light microscopy. After cell invasion, only parasitophorous vacuoles containing a single zoite were observed. Five days post-inoculation with sporozoites, unstained cell monolayers were evaluated by differential interference contrast (DIC), and also by Romanovsky stain using conventional light microscopy. Single zoites, each surrounded by a cyst wall, were observed by both methods. Multiplication by endodyogeny did not occur in any cell monolayer. Treatment of encysted parasites with HCl-pepsin for 15 min led to dissolution of the cyst wall and release of intact and motile zoites. To our knowledge, this is the first demonstration of in vitro production of monozoic tissue cysts of C. felis. As kittens commonly shed C. felis in their feces, oocysts are easily available for in vitro production of monozoic tissue cysts of the parasite. Development of C. felis in cell culture may be employed as a model on tissue cyst formation of Cystoisospora spp. and closely related coccidia.

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RESUMEN Introducción: A pesar de terapia antiretroviral aún es común encontrar la presencia de infecciones oportunistas, tales como enteroparásitos que causan un gran impacto en salud y economía de los pacientes. Objetivos: Determinar la frecuencia, etiología y factores asociados a las enteroparasitosis en pacientes con VIH, en un hospital referencial de Lambayeque, Perú. Material y Métodos: Se realizó un estudio prospectivo tipo observacional en pacientes diarreicos con infección por VIH de un hospital de Lambayeque desde enero a junio del 2016. Tanto la recolección y transporte, como el análisis de las muestras siguieron las recomendaciones del Manual de procedimientos para el diagnóstico de las parasitosis humanas del Instituto Nacional de Salud. Resultados: La mediana de edad fue 28 años, predominó el sexo masculino y el porcentaje de parasitismo fue de 73,08%. Pacientes con carga viral > 1000 fueron 69,2% y pacientes en TARGA fueron 55,8%. Blastocystis hominis fue el parásito más frecuente (30,77%), seguida de Cryptosporidium spp. y Cystoisospora belli con el 21,2% y 11,5% respectivamente. El análisis bivariado entre carga viral y TARGA con parasitismo, demostró asociación con el parasitismo. Conclusiones: La enteroparasitosis es frecuente en pacientes con VIH y diarrea, predominando las infecciones oportunistas por encima de las no oportunistas.

ABSTRACT Introduction: Despite antiretroviral therapy, it is still common to find the presence of opportunistic infections such as enteroparasites, which cause a big impact on the health and economy of patients. Objetive: To determine the frequency, etiology and factors associated with enteroparasitosis in patients with HIV at a reference hospital in Lambayeque, Peru. Material and Methods: A prospective observational study was conducted in diarrheic patients with HIV infection in a hospital in Lambayeque from January to June, 2016. The study was a census. Both the collection and transport as well as the analysis of the samples followed the recommendations of the Manual of procedures for the diagnosis of human parasitosis of the National Institute of Health. Results: The meadian age was 28 years, the male sex predominated, and the percentage of parasitism was 73.08%. Patients with viral load >1000 were 69.2% and patients with HAART were 55.8%. Blastocystis hominis was the most frequent parasite (30.77%), followed by Cryptosporidium spp. and Cystoisospora belli with 21.2% and 11.5%, respectively. The bivariate analysis between viral load and HAART with parasitism, demonstrated an association with parasitism. Conclusions: Enteroparasitosis is frequent in patients with HIV and diarrhea, predominating opportunistic infections over non opportunistic ones.

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Abstract Cystoisospora belli infection manifests as diarrhea, and can potentially progress to malabsorption in HIV patients. Here, we report a case of C. belli infection in an HIV/AIDS patient with chronic diarrhea symptoms for at least 2 years. Coproscopic analyses based on direct technique and modified Ziehl-Neelsen technique without a commercial kit were performed. The current case report highlights the protocol to be adopted in coproscopic analyses applied to HIV patients. The importance of including the appropriate parasitological testing of patients with chronic intestinal isosporiasis in parasitological test routines must be considered.

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Acute diarrhea in young dogs is among the main complaints described by tutors in veterinary services. Complications related to water and electrolyte imbalances due to intestinal alterations can compromise homeostasis in these pups, mainly due to dehydration. Consequently, they do not present a satisfactory clinical response and are exposed to the risk of early death. Among the different types of diarrhea, the infectious diarrhea due to viruses, bacteria, and parasites are particularly significant. Coccidia of the genus Isospora (Cystoisospora spp.) is an important intestinal pathogen that causes severe clinical manifestations in puppies. Since high parasitic loads render these puppies highly susceptible to opportunistic infections, coccidia infection may cause impaired corporal and cognitive development and even lead to death. Studies regarding this issue, particularly concerning clinical knowledge in neonatology, are scarce in veterinary medicine. Thus, in this study, we intend to discuss the enteric alterations and the most commonly used current diagnostic techniques, as well as to analyze effective therapeutic and prophylactic proposals.

As diarreias agudas em cães jovens estão entre as principais queixas descritas pelos tutores nos serviços veterinários. As complicações relacionadas aos desequilíbrios hídrico e eletrolítico decorrentes das alterações intestinais comprometem a homeostase destes filhotes, principalmente devido a desidratação, não apresentam resposta clínica satisfatória e ficam expostos ao risco de morte precoce. Dentre os diferentes tipos de diarreia, sobressaem as de origem infecciosa. Os agentes podem ser vírus, bactérias, fungos e parasitos. Entre estes últimos agentes, os coccídios do Gênero Isospora (Cystoisospora spp.) se destacam como patógenos intestinais que ocasionam manifestações clínicas graves em filhotes, pois elevadas cargas parasitárias propiciam condição de maior susceptibilidade à infecções oportunistas, podendo também prejudicar o desenvolvimento corporal e cognitivo e/ou até mesmo levar a morte do cão. Diante de tal temática, na medicina veterinária os estudos são escassos, principalmente quanto ao conhecimento clínico em neonatologia de tal modo tencionamos discutir a respeito das alterações entéricas, métodos de diagnóstico mais utilizados e atuais, bem como analisar as propostas terapêuticas e profiláticas efetivas.

RESUMO

Acute diarrhea in young dogs is among the main complaints described by tutors in veterinary services. Complications related to water and electrolyte imbalances due to intestinal alterations can compromise homeostasis in these pups, mainly due to dehydration. Consequently, they do not present a satisfactory clinical response and are exposed to the risk of early death. Among the different types of diarrhea, the infectious diarrhea due to viruses, bacteria, and parasites are particularly significant. Coccidia of the genus Isospora (Cystoisospora spp.) is an important intestinal pathogen that causes severe clinical manifestations in puppies. Since high parasitic loads render these puppies highly susceptible to opportunistic infections, coccidia infection may cause impaired corporal and cognitive development and even lead to death. Studies regarding this issue, particularly concerning clinical knowledge in neonatology, are scarce in veterinary medicine. Thus, in this study, we intend to discuss the enteric alterations and the most commonly used current diagnostic techniques, as well as to analyze effective therapeutic and prophylactic proposals.

As diarreias agudas em cães jovens estão entre as principais queixas descritas pelos tutores nos serviços veterinários. As complicações relacionadas aos desequilíbrios hídrico e eletrolítico decorrentes das alterações intestinais comprometem a homeostase destes filhotes, principalmente devido a desidratação, não apresentam resposta clínica satisfatória e ficam expostos ao risco de morte precoce. Dentre os diferentes tipos de diarreia, sobressaem as de origem infecciosa. Os agentes podem ser vírus, bactérias, fungos e parasitos. Entre estes últimos agentes, os coccídios do Gênero Isospora (Cystoisospora spp.) se destacam como patógenos intestinais que ocasionam manifestações clínicas graves em filhotes, pois elevadas cargas parasitárias propiciam condição de maior susceptibilidade à infecções oportunistas, podendo também prejudicar o desenvolvimento corporal e cognitivo e/ou até mesmo levar a morte do cão. Diante de tal temática, na medicina veterinária os estudos são escassos, principalmente quanto ao conhecimento clínico em neonatologia de tal modo tencionamos discutir a respeito das alterações entéricas, métodos de diagnóstico mais utilizados e atuais, bem como analisar as propostas terapêuticas e profiláticas efetivas.

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HTLV-1 es un retrovirus endémico en Perú, relacionado ocasionalmente con algunas infecciones oportunistas aisladas. Presentamos el caso de un varón de 41 años, avicultor, con antecedente de TBC pulmonar tratado hace 6 meses. Ingresó a emergencia por presentar alteración de conciencia, disartria y diarrea acuosa. Al examen físico se evidenciaron placas confluentes en cavidad oral, lesiones máculo-papulares violáceas y placas costrosas; por biopsia de piel se confirmó sarcoma de Kaposi y sarna costrosa, además adenopatías cervicales que al estudio microscópico con test de Auramina mostró BAAR (++) y en el examen de heces con tinción Zielh Nielsen modificado, se evidenció ooquiste de Cystoisospora belli. Recibió trimetropin / sulfametozaxol, tratamiento antituberculoso. Se confirmó HTLV-1 por inmunofluorescencia. En el fondo de ojo se observó retinitis por citomegalovirus, recibió ganciclovir. A las tres semanas del ingreso hospitalario, falleció por insuficiencia respiratoria severa. Se discute la presencia de múltiples co-infecciones oportunistas en un paciente con inmunosupresión por HTLV-1.

HTLV-1 is an endemic retrovirus in Peru , occasionally associated with some isolated opportunistic infections. We present the case of a 41-year-old male poultry farmer with a history of pulmonary tuberculosis treated 6 months ago. He was admitted to emergency due to alteration of conscience, dysarthria and watery diarrhea; the examination revealed confluent plaques in the oral cavity, violaceous maculopapular lesions and crusted plaques. Skin biopsy confirmed Kaposi's sarcoma and crusted scabies; in addition, cervical lymphadenopathies showed evidence of BAAR (++) in the microscopic study with Auramine test, and in the examination of feces with modified Zielh Nielsen's stain, Cystoisospora belli oocyst was observed, and trimetropin / sulfametozaxol received antituberculous treatment. HTLV-1 was confirmed by immunofluorescence. In the fundus of the eye cytomegalovirus retinitis was evidenced, he received ganciclovir. At three weeks of hospital admission he died due to severe respiratory failure. We discuss the presence of multiple opportunistic co-infections in a patient with immunosuppression by HTLV-1.

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Resumen Introducción: Las coccidiosis intestinales ocasionadas por Cryptosporidium, Cystoisospora belli y entre abril- junio de 2015, se realizó un estudio prospectivo, descriptivo y transversal para Cyclospora cayetanensis constituyen patologías parasitarias de alta relevancia en la Salud Pública. Objetivo: Determinar la prevalencia y parámetros epidemiológicos de coccidiosis intestinales en 188 habitantes de "El Hato", Estado Falcón, Venezuela. Metodología: Para la identificación de los probables factores de riesgos asociados a las coccidiosis intestinales se usó una ficha encuesta-epidemiológica. El diagnóstico parasitológico se realizó con el método directo y la coloración de Kinyoun. Resultados: La prevalencia global de parasitosis intestinales fue 64,36%, siendo Blastocystis spp. el taxón más frecuentemente observado (39,89%). La prevalencia de coccidios intestinales fue 37,23%, observándose prevalencias de 32,98% para Cyclospora cayetanensis, 26,60% para Cryptosporidium spp. y 3,19% para Cystoisospora belli. Con la aplicación del análisis de regresión logística múltiple se determinó como potenciales factores de riesgo independientes significativamente involucrados en la transmisión de las entero-coccidiosis: lavado inadecuado de manos [Odds Ratio (OR) = 1,89], el consumo de "comidas rápidas" (OR=1,26), empleo del agua más frecuentemente para aseo personal y lavado de vestimentas (OR=2,88), tener un nivel socio-económico bajo (nivel IV/V-Graffar) (OR=1,41), nivel de instrucción de la madre (primaria/secundaria) (OR=0,53), que se realice limpieza del hogar interdiario (OR=2,95), y que se posea animales (OR=2,06). Conclusiones: Los hallazgos de esta investigación muestran que las infecciones ocasionadas por los coccidios intestinales aun representan un problema de salud pública en las áreas rurales de Venezuela.

Abstract Introduction: Intestinal coccidioses caused by Cryptosporidium sp., Cystoisospora belli and Cyclospora cayetanensis are parasitic diseases of major clinical importance in Public Health. Objective: Between April to June 2015, a prospective, descriptive and cross-sectional survey was designed to determine the prevalence and epidemiological profiles of intestinal coccidioses in 188 inhabitants of "El Hato", Falcon State, Venezuela. Methods: Probable risk factors for intestinal coccidioses were identified by using epidemiological questionnaires. The diagnosis of coccidian infection was made by direct wet-mounting and Kinyoun staining. Results: The overall prevalence of intestinal parasitosis was 64.36%, and Blastocystis spp. was the most prevalent taxa (39.89%). Enterococcidioses prevalence was 37.23%, detecting prevalence values of 32.98% for Cyclospora cayetanensis, 26.60% for Cryptosporidium spp. and 3.19% for Cystoisospora belli. Multiple logistic regression analysis allowed us to determine as independent potential risk factors for transmission of these enterococciodioses: inappropriate hand washing [Odds Ratio (OR) = 1.89], fast food consumption (OR=1.26), major use of water for personal and clothes washing (OR=2.88), low socio-economic status (level IV/V-Graffar) (OR=1.41), mother's educational status (primary/secondary school) (OR=0.53), non-daily home cleaning (OR=2.95), and keeping domestic animals (OR=2.06). Conclusions: Findings of this study showed that infections caused by intestinal coccidian infections are still remains as a serious health problem in rural areas of Venezuela.

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Se condujo una investigación en Venezuela con la finalidad de conocer algunos aspectos epidemiológicos sobre la presencia de Cystoisospora suis en 67 granjas porcinas intensivas. Para la determinación de la carga parasitaria se seleccionaron 572 camadas con signos de diarrea, así como 1.712 muestras fecales de cerdos adultos. Las muestras se cultivaron en dicromato de potasio al 2,5% y posteriormente se procesaron mediante una técnica copro-parasitológica. Además, en cada granja se aplicó una encuesta epidemiológica. El protozoario se encontró en 55 granjas (82,1%) y 210 camadas (36,7%). Al referirlo a camadas, se observaron ooquistes en lechones menores de tres días de edad, lo que podría indicar la existencia de rutas alternativas de la infección. En cerdos adultos se encontró correlación significativa (rho = 0,35; P < 0,05) entre la excreción de ooquistes en lechones y en madres, lo que sugiere que estas podrían actuar como fuentes de infección. Se constató correlación entre el número de partos de la cerda y la prevalencia en camadas y cerdas lactantes (P < 0,05), pues, a mayor número de partos, disminuye la prevalencia. Probablemente estos hallazgos están asociados con mecanismos inmunológicos desconocidos. El tamaño de la granja no afectó la presencia del parásito; sin embargo, las granjas con pisos plásticos mostraron mayor control de la infección. Se concluye que algunos mecanismos inmunológicos, aún sin dilucidar, podrían estar involucrados en la cadena de transmisión del protozoario, los cuales podrían jugar un papel importante en el desarrollo de la cystoisosporosis porcina.

It was carried out an investigation in Venezuela with the aim of studying the epidemiological aspects of Cystoisospora suis in intensive swine herds. Sixty-seven intensive swine herds were included. For parasite determination 572 litters with signs of diarrhea, as well as 1,712 faecal samples from mature pigs were selected. Stool samples were cultured in a 2.5% potassium dichromate solution and later processed by copro-parasitological technique. Epidemiological surveys were applied on each farm. The results indicated that C. suis was observed in 55 herds (82.1%) and 210 litters (36.7%). Regarding to litters, oocysts were observed in piglets less than three days of life, which could indicate the existence of alternative infection way. Regarding to mature pigs, there was a significant correlation (rho = 0.35; P < 0.05) among oocysts excretion in piglets and sows, suggesting that sows may act as infection sources. Sows parity was statistically correlated with the prevalence values in litters as in lactating sows (P < 0.05). This might indicate that as parity increase, prevalence decreases in these groups. Probably, these findings are associated with unknown immunologic mechanisms. The herd size did not affect the presence of the parasite, however, farms with plastic floors showed greater control of the infection. It is concluded that non elucidated immunologic mechanisms might be involved in the protozoa transmission cycle and play an important role in the development of porcine cystoisosporosis.

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Entre enero y junio de 2014 se condujo una investigación en la región central de Venezuela con la finalidad de determinar la prevalencia del enterococcidio Cystoisospora suis en granjas porcinas intensivas. Para la determinación parasitaria se seleccionaron 572 camadas con signos de diarrea, así como 1.712 muestras fecales de cerdos adultos. Todas las muestras se cultivaron en dicromato de potasio al 2,5% y posteriormente se procesaron mediante una técnica coproparasitológica. Los resultados señalan que C. suis se encontró en 55 granjas (82,1%) y 210 camadas (36,7%), con los mayores valores de prevalencia en las dos primeras semanas de vida (P < 0,05). Al referir los resultados en cerdos adultos se encontró correlación significativa (rho = 0,35; P < 0,05) entre excreción de ooquistes en lechones y madres, lo que sugiere que cerdas madres podrían actuar como fuentes de infección. Se encontró correlación entre el número de partos de la cerda y los valores de prevalencia en camadas y cerdas lactantes (P < 0,05) lo que indica que, a mayor número de partos, disminuye la prevalencia. Probablemente estos hallazgos se asocian con mecanismos inmunológicos desconocidos. Se concluye que C. suis se encuentra ampliamente distribuido en Venezuela y que el enterococcidio puede ser controlado mejorando las condiciones higiénicas de las granjas; sin embargo, hay mecanismos inmunológicos aún sin dilucidar que podrían incidir en la cadena de transmisión del protozoario.

It was carried out an investigation at the central region of Venezuela from January to June 2014 with the aim to determine the prevalence of coccidian Cystoisospora suis in intensive swine herds. For parasitic determination 572 litters were selected with signs of diarrhea. Likewise, 1.712 fecal samples were also collected in mature pigs. Stool samples were cultured in a 2.5% potassium dichromate solution and later processed by coprological technique. The results of this investigation indicated that C. suis was observed in 55 herds (82.1%) and 210 litters (36.7%) with the highest prevalence values in first two weeks of age (P < 0.05). Regarding to mature pigs, there was a significant correlation (rho = 0.35; P < 0.05) among oocysts excretion in piglets and sows, suggesting that sows may act as infection sources. Sows parity was statistically correlated with the prevalence values in litters as in lactating sows (P < 0.05). This might indicate that as parity increase, prevalence decreases in these groups. Probably these findings are associated with unknown immunologic mechanisms. It is concluding that C. suis is broadly distributed in Venezuela and it could be controlled by improving conditions sanitary herd, however, non elucidated immunologic mechanisms might be involved in the protozoa transmission cycle.

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Cryptosporidium spp. and Cystoisospora belli are monoxenic protozoa that have been recognized as the causative agents of chronic diarrhea in immunocompromised individuals, especially HIV-infected subjects. The objective of this study was to evaluate the frequency of these intestinal protozoa in HIV-positive patients in the Triângulo Mineiro region of Brazil and to correlate the presence of these infections with clinical, epidemiological and laboratory data of the patients. Oocysts were detected in stool samples of 10 (16.9%) of the 59 patients studied, while Cryptosporidium spp. were present in 10.1% (6/59) and C. belli in 6.7% (4/59). The frequency of these parasites was higher among patients with diarrheic syndrome and CD4+ T lymphocyte counts < 200 cells/mm 3 , demonstrating the opportunistic characteristic of these infections. A significant association was observed between the lack of adherence to antiretroviral therapy and the presence of Cryptosporidium spp. and/or C. belli. Parasitism with Cryptosporidium spp. was more frequent in February and April, the months following the period of high rainfall. The same was not observed for C. belli. Genetic characterization of two isolates led to the identification of Cryptosporidium parvum, one of the main species associated with the zoonotic transmission of cryptosporidiosis.

Cryptosporidium spp. e Cystoisospora belli são protozoários monoxenos reconhecidos como agentes causadores de diarréia crônica em indivíduos imunocomprometidos, especialmente aqueles infectados pelo HIV. Os objetivos deste estudo foram o de avaliar a frequência destes protozoários em pacientes HIV - positivos na região do Triângulo Mineiro, Brasil, e correlacionar a presença destas infecções com dados clínicos, epidemiológicos e laboratoriais dos pacientes. Oocistos foram detectados em amostras fecais de 10 (16,9%) dos 59 pacientes estudados, sendo 10.1% (6/59) das amostras positivas para Cryptosporidium spp. e 6,7% (4/59) das amostras positivas para C. belli. A frequência destes parasitos foi maior entre pacientes com síndrome diarreica e contagem de linfócitos T CD4+ < 200 cells/mm 3 , o que demonstra o caráter oportunista destas infecções. Foi observada uma associação significativa entre a falta de aderência à terapia antiretroviral e a presença de Cryptosporidium spp. e/ou C. belli. Parasitismo por Cryptosporidium spp. foi mais frequente em fevereiro e abril, meses subsequentes ao período chuvoso. O mesmo não foi observado para C. belli. A caracterização genética de dois isolados levou à identificação de Cryptosporidium parvum, uma das principais espécies associadas com a transmissão zoonótica da criptosporidiose.

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The impact of Cystoisospora felis infection on the nutritional efficiency of gerbils was studied. The variables weight gain and feed intake were measured during four weeks in 28 laboratory gerbils, of which 14 were inoculated with 3.5 × 10(5) sporulated oocysts of C. felis and the remaining 14 were controls. The animals from both groups were weighted, killed, eviscerated and had their carcasses and tissues weighted and compared. A modern tool designed for measuring nutritional performance of farm animals was applied. The results showed compromised nutritional efficiency of the infected animals within the first week after infection. The consequences of these results are discussed here, including the potential impact of infection on farm animals performance.(AU)

O impacto da infecção por Cystoisospora felis na eficiência nutricional de gerbis foi estudado. As variáveis ganho de peso e consumo de ração foram mensuradas durante quatro semanas em 28 gerbis de laboratório, dos quais 14 foram inoculados com 3,5 × 10(5) oocistos esporulados de C. felis e os 14 restantes serviram como controle. Os animais de ambos os grupos foram pesados, mortos, eviscerados e tiveram suas carcaças e tecidos pesados e comparados. Uma ferramenta moderna desenvolvida para mensurar o desempenho nutricional de animais de produção foi aplicada. Os resultados mostraram eficiência nutricional comprometida dos animais infectados na primeira semana após a infecção. As consequências destes resultados são discutidas aqui, incluindo o possível impacto de infecção no desempenho de animais de produção.(AU)

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The impact of Cystoisospora felis infection on the nutritional efficiency of gerbils was studied. The variables weight gain and feed intake were measured during four weeks in 28 laboratory gerbils, of which 14 were inoculated with 3.5 × 10(5) sporulated oocysts of C. felis and the remaining 14 were controls. The animals from both groups were weighted, killed, eviscerated and had their carcasses and tissues weighted and compared. A modern tool designed for measuring nutritional performance of farm animals was applied. The results showed compromised nutritional efficiency of the infected animals within the first week after infection. The consequences of these results are discussed here, including the potential impact of infection on farm animals performance.

O impacto da infecção por Cystoisospora felis na eficiência nutricional de gerbis foi estudado. As variáveis ganho de peso e consumo de ração foram mensuradas durante quatro semanas em 28 gerbis de laboratório, dos quais 14 foram inoculados com 3,5 × 10(5) oocistos esporulados de C. felis e os 14 restantes serviram como controle. Os animais de ambos os grupos foram pesados, mortos, eviscerados e tiveram suas carcaças e tecidos pesados e comparados. Uma ferramenta moderna desenvolvida para mensurar o desempenho nutricional de animais de produção foi aplicada. Os resultados mostraram eficiência nutricional comprometida dos animais infectados na primeira semana após a infecção. As consequências destes resultados são discutidas aqui, incluindo o possível impacto de infecção no desempenho de animais de produção.

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