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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In recent years, introduction of new and more effective agents has improved the overall therapy for parasitic infections. This field, however, is still plagued by numerous problems, including the development of resistance to antimicrobial agents (especially with malaria), unavailability of agents in the United States or lack of approval by the Food and Drug Administration, and major toxicities or lack of experience in pregnant women and children, which limits use in these groups of patients. Widespread resistance of Plasmodium falciparum to chloroquine and other agents has complicated the treatment and prophylaxis of this type of malaria. A combination of quinine and Fansidar is usually effective oral therapy for falciparum malaria; quinidine may be administered if intravenous therapy is needed. Mefloquine, which is currently recommended for prophylaxis against chloroquine-resistant P. falciparum, is also effective for single-dose oral treatment, although this regimen has not yet been approved by the Food and Drug Administration. Metronidazole has been widely used for treatment of gastroenteritis due to Entamoeba histolytica and Giardia lamblia (not approved by the Food and Drug Administration for the latter) and is considered safe and effective. A new macrolide, azithromycin, has been reported to be effective for cryptosporidiosis in experimental animals; currently, no effective therapy is available for human infections. Combinations of sulfonamides with other antifolates, trimethoprim or pyrimethamine, are recommended therapy for Pneumocystis carinii pneumonia or toxoplasmosis, respectively. Therapies for the various types of leishmaniasis and trypanosomiasis are complex, often toxic, and often of limited efficacy. The benzimidazoles are effective for roundworm infections, although thiabendazole has severe toxic effects. The recent introduction of ivermectin has revolutionized the treatment and control of onchocerciasis. Another relatively new agent, praziquantel, is a true broad-spectrum anthelmintic agent that is effective against most trematodes, many adult cestodes, and larval cestodes as well (especially cysticerci of Taenia solium).
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PMID:Antiparasitic agents. 154 96

The fecal samples submitted for routine ova and parasite examination in Children's Hospital, Bangkok, Thailand, between October 1984 and November 1987, were investigated for Cryptosporidial oocysts, indicated that the prevalence was 1.61 per cent. The infection played an important role in aetiology of gastroenteritis and/or diarrhea. Because the children, particularly those less than 2 years of age who had watery and non-bloody stools and accompanied with gastrointestinal symptoms were found to have Cryptosporidium oocysts, almost (84.31%) of the infected children were hospitalized. Suggestively, Cryptosporidiosis should be included in the diagnosis of diarrheal disease in children and diarrheal illness in immunocompetent patients. In this report, the source of infection and the route of transmission was not identified but 80.39 per cent of children with cryptosporidiosis children were admitted with primary diagnosis of diarrhea together with pneumonia. The medication was Furazolidone or the combination of Trimethoprime and Sulphamethoxazone.
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PMID:Cryptosporidium oocysts in stool specimens submitted to routine ova & parasite examination: 38 months survey. 176 40

During an 18 months' survey of children admitted to hospital with gastroenteritis, oocysts of the protozoan Cryptosporidium were detected in 35 cases (1.6% of the total 2205 surveyed). The affected children (age range 5 months to 8 years; mean 34.2 months) were immunocompetent, and had green and offensive watery diarrhoea. Vomiting (94%) with dehydration (80%), fever (66%) and abdominal pain (26%) were major clinical features of the diarrhoeal illness which lasted a mean 8.2 (range 3-14) days. Five children were infected with other enteropathogens. The illness was self-limiting in all cases and none were excreting oocysts 2 weeks after cessation of diarrhoea. Peak incidence occurred during the months of March and April, with no cases during the hottest months of July and August. There was no known contact with animals or pets; 4 children had other siblings affected and 2 conformed to cases of travellers' diarrhoea. The significance of cryptosporidiosis in Kuwait and the need for epidemiological studies are discussed.
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PMID:Cryptosporidium gastroenteritis in immunocompetent children from Kuwait. 226 Feb 6

During January through June 1988, oocysts of Cryptosporidium were identified in fecal samples of 83 (7.7%) of 1073 children who presented with acute gastroenteritis. Other intestinal pathogens were less common: Salmonella 4.2%, E. coli 1.9%, Shigella 2.6% and Campylobacter jejuni 5.0%. Cryptosporidiosis (C) was more common under the age of 5 years than over (8.4% vs 1.8%, respectively, p less than 0.01). In 6 (7.2%) children with C, another stool pathogen was found. Frequent signs of C were diarrhea (85.4%), vomiting (36.3%) and fever (32.7%). Although no anticryptosporidial treatment was given, most children recovered within 5-9 days, but 6 had to be hospitalized: 4 were dehydrated and 5 had electrolyte imbalance. Repeated examination showed persistence of oocysts in the stools for up to 19 days. We conclude that C is a significant cause of gastroenteritis in Israeli children under the age of 5 years which occasionally requires hospitalization. We therefore recommend routine examination for C in cases of acute gastroenteritis.
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PMID:[Cryptosporidiosis in children]. 234 32

From April 16 1987 through May 16 1987, during an outbreak of gastroenteritis, stool specimens were obtained from 53 children aged 18 to 36 months among the 90 children attending an on-site day-care center for the staff of a large teaching hospital in the Paris urban area (59%). Oocysts of Cryptosporidium were found in 11 specimens (21%) using an auramine staining technique. Children with diarrhea were more likely to have stools containing Cryptosporidium (p less than 0.01). Subsequently, a prospective study was carried out in the same day care center from July 1987 through January 1988. Among the 103 episodes of diarrhea observed during the study period, there were five cases of cryptosporidiosis (5%). In all these cases, diarrhea was moderate and resolved within ten days. Furthermore, among 148 hospitalized children aged 2 months to 10 years, 2 (1.4%) had positive stool specimens for Cryptosporidium and significant failure to thrive. Thus, Cryptosporidium is a common cause of diarrhea in immunocompetent children, especially in child group settings. Further studies are needed to determine the prevalence and spectrum of the clinical patterns of this parasitic disease.
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PMID:[Cryptosporidiosis in children: epidemics and sporadic cases]. 240 Jan 92

By using the elective diagnosis methodology for Cryptosporidium (modified Ziehl-Neelsen and Heine stainings), 481 faeces samples from patients--children and adults--presenting acute or prolonged gastroenteritis and also from asymptomatic ones, but with professional, immunological or pharmacological risk for infection, were studied. Twelve Cryptosporidium positive cases were identified, meaning a general prevalence of 2.48% Cryptosporidium infection was detected in all investigated epidemiological groups: children, animal handlers, immunodeficient patients, immunocompetent adults with acute gastroenteritis. The risk factors hierarchy elicited the role of children collectivities attending, for acquiring the parasite in infantile cryptosporidiosis, while the opportunistic and zoonotic feature of the disease was especially present in adults' cryptosporidiosis. The assessment of cryptosporidiosis evolution, according to patients' immune status, has not allowed an obvious clinical discrepancy, since the immunocompetent subjects with professional risk had presented a prolonged oocysts excretion. The different clinico-epidemiological and parasitological features of Cryptosporidium infection are commented and the importance of applying Cryptosporidium methodology in current diagnosis practice is emphasized.
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PMID:Cryptosporidiosis in children and adults: parasitological and clinico-epidemiological features. 248 7

Between January 12 and February 7, 1987, an outbreak of gastroenteritis affected an estimated 13,000 people in a county of 64,900 residents in western Georgia. Cryptosporidium oocysts were identified in the stools of 58 of 147 patients with gastroenteritis (39 percent) tested during the outbreak. Studies for bacterial, viral, and other parasitic pathogens failed to implicate any other agent. In a random telephone survey, 299 of 489 household members exposed to the public water supply (61 percent) reported gastrointestinal illness, as compared with 64 of 322 (20 percent) who were not exposed (relative risk, 3.1; 95 percent confidence interval, 2.4 to 3.9). The prevalence of IgG to cryptosporidium was significantly higher among exposed respondents to the survey who had become ill than among nonresident controls. Cryptosporidium oocysts were identified in samples of treated public water with use of a monoclonal-antibody test. Although the sand-filtered and chlorinated water system met all regulatory-agency quality standards, sub-optimal flocculation and filtration probably allowed the parasite to pass into the drinking-water supply. Low-level cryptosporidium infection in cattle in the watershed and a sewage overflow were considered as possible contributors to the contamination of the surface-water supply. We conclude that current standards for the treatment of public water supplies may not prevent the contamination of drinking water by cryptosporidium, with consequent outbreaks of cryptosporidiosis.
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PMID:Large community outbreak of cryptosporidiosis due to contamination of a filtered public water supply. 271 83

Cryptosporidiosis has typically been considered a disease of animals, and the occasional human case has been considered a rare zoonosis or evidence of immunoincompetence. In this report, person-to-person transmission is postulated for illness documented in two of five rooms of a day-care center. Of 46 persons (34 children and 12 staff members), 29 (63%) became ill, and 27 (58.7%) had Cryptosporidium in their stools. Symptoms in children included diarrhea (55%), weight loss (25%), flatulence (15%), and fever (10%). Symptoms of cryptosporidiosis ceased without treatment, and three months later all previously infested children had negative stool specimens. Questionnaires administered to parents revealed no association with water, travel, or ill pets. Cultures for Salmonella, Shigella, and Campylobacter were negative; no viral cultures were done. All affected children and their parents were immunocompetent. It is presumed that this outbreak occurred as a result of person-to-person transmission of the protozoa in the day-care centers, primarily by staff with inadequate hygiene practices. Physicians should look for this organism in children or adults who present with diarrhea and gastroenteritis in which the pathogenic agent is not readily identifiable by the usual bacterial cultures.
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PMID:Cryptosporidiosis in a day-care center. 273 10

A 4-year-old FeLV-positive cat with a 1-year history of intermittent diarrhea and subsequent anorexia, depression, and weight loss had enteric cryptosporidiosis at necropsy. Cryptosporidium sp is an important cause of gastroenteritis and diarrhea in various species, including human beings with acquired immunodeficiency syndrome. A major determinant of the severity of the disease caused by Cryptosporidium sp is the immunologic status of the affected animal. Cryptosporidiosis should be included in the differential diagnosis of protracted diarrhea in FeLV-positive cats. Because cryptosporidiosis now is recognized as a zoonosis, cats with this disease should be considered a potential source of human infection.
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PMID:Cryptosporidiosis in a feline leukemia virus-positive cat. 282 11

In this review I have examined the vast literature which has accumulated on Cryptosporidium, particularly in the past 3 years, in an attempt to highlight areas in which progress has been made in relation to the organism and the disease, and to indicate areas in which knowledge is still lacking. Since 1982, a global effort by scientists and clinicians has been directed towards determining the nature of the disease in humans and the relative contribution of cryptosporidiosis to gastroenteritis. From published data, the incidence of diarrhoea is 1-5% in most developed countries, and 4-7% in less developed countries, when measured throughout the year and in all age groups. The frequency of cryptosporidiosis is highest in children aged between 6 months and 3 years, and in particular locations (e.g., day-care centres) and at particular times of the year. Although susceptibility to infection is life-long, one suspects that the lower prevalence among older children and adults is due to immunity acquired from frequent exposure. Other important factors contributing to higher prevalence are the season--it is more frequent in a wet, warm climate--association with travel to particular destinations, poor hygiene, intimate contact with certain animals, and congregation of large numbers of young previously unexposed children in day-care centres. The association between cryptosporidiosis and giardiasis presumably results from the existence of a common source of infection. The immune status of the host appears to be a major determinant of whether the infection is self-limiting or persistent. It is clear that both branches of the immune system are required for complete recovery, since T-lymphocyte dysfunction or hypogammaglobulinaemia can both lead to persistent illness. Chronic diarrhoea and malabsorption attributed to cryptosporidiosis also occur in the absence of evidence of immune defect. The importance of respiratory tract infection in humans, other than in the terminal stages of chronic illness, requires investigation. The infection has now been identified in all classes of vertebrates; it has been observed in all domestic animals including pets, and a wide range of wildlife including birds. Cryptosporidiosis seems to cause diarrhoea in young ruminants, less frequently in pets. In birds the parasite has been observed in the gastrointestinal tract, without ill effect, and in the respiratory tract, in which clinical symptoms of variable severity have been described. The mucosal response of the gastrointestinal tract to infection appears to vary among mammals and may be the key to the variable clinical manifestations observed.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Cryptosporidiosis in perspective. 328 31


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