Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Infect Dis. May 25, 2017; 7(2): 32-37
Published online May 25, 2017. doi: 10.5495/wjcid.v7.i2.32
Disseminated cryptosporidiosis: Case report and literature review
Shehla Khalil, Bijay R Mirdha, Jaishree Paul, Ashutosh Panda, Yogita Singh
Shehla Khalil, Bijay R Mirdha, Ashutosh Panda, Yogita Singh, Department of Microbiology, All India Institute of Medical Sciences, New Delhi 110029, India
Jaishree Paul, School of Life Sciences, Jawaharlal Nehru University, New Delhi 110067, India
Author contributions: Khalil S, Mirdha BR and Paul J designed the report; Khalil S, Panda A and Singh Y performed experiments; Khalil S, Panda A and Singh Y collected the patient’s clinical data; Khalil S, Mirdha BR and Paul J analyzed the data and wrote the paper.
Supported by Council of Scientific and Industrial Research, Government of India.
Institutional review board statement: The study was approved by Institutional Ethics Committee of All India Institute of Medical Sciences, New Delhi, India.
Informed consent statement: All the participants were apprised about the study protocol. During the meetings, enrolled individuals (guardians/parents in case of children) were informed that their participation is voluntary and they have all the rights to withdraw from the study at any time without giving any reason.
Conflict-of-interest statement: Authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Bijay R Mirdha, MD, Professor, Department of Microbiology, All India Institute of Medical Sciences, Room No. 2078, Teaching Block, Ansari Nagar, New Delhi 110029, India. mirdhabr2078@gmail.com
Telephone: +91-11-26594614
Received: April 18, 2016
Peer-review started: April 19, 2016
First decision: May 17, 2016
Revised: January 31, 2017
Accepted: February 20, 2017
Article in press: February 21, 2017
Published online: May 25, 2017
Abstract

Cryptosporidiosis, better known as an intestinal disease may disseminate to infect other sites including the respiratory tract. Little information however is available on respiratory cryptosporidiosis that may largely be due to lower frequency of respiratory cryptosporidiosis. Respiratory cryptosporidiosis has been majorly reported in immunocompromised individuals and children. Here we report a case of respiratory and intestinal cryptosporidiosis in a fifteen months old child with CD8+ deficiency. The patient in spite of treatment with Nitazoxanide and Azithromycin followed by Intravenous immunoglobulin and Bovine colostrum had a fatal outcome. The Cryptosporidium spp. isolate was subjected to molecular characterization. The Cryptosporidium spp. was identified both in stool specimen and Endotracheal aspirate (ETA). The blood sample was negative for Cryptosporidium spp. The Cryptosporidium spp. isolate from stool as well as ETA was identified as Cryptosporidium hominis (C. hominis) using Multiplex Allele Specific Polymerase Chain Reaction assay and was subtyped as IaA23G1R1 subtype using gp60 gene polymerase chain reaction assay followed by sequencing.

Keywords: Cryptosporidiosis, Disseminated disease, CD8+ deficiency, Cryptosporidium hominis, Subtyping

Core tip: Disseminated cryptosporidiosis has rarely been reported because of the lower frequency as compared to intestinal cryptosporidiosis. Here we describe a case of patient who developed intestinal cryptosporidiosis followed by respiratory cryptosporidiosis. The Cryptosporidium isolate was identified as Cryptosporidium hominis subtype IaA23R2.