Understanding intestinal spore-forming protozoa: Cryptosporidia, microsporidia, isospora, and cyclospora

Annals of Internal Medicine

Volumn 124, Issue 4, 1996, Pages 429-441

  Goodgame, Richard W ^a,b  

^a BEN TAUB GENERAL HOSPITAL   (United States)

^b BAYLOR COLLEGE OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CRYPTOSPORIDIUM; CYCLOSPORA; DATA BASE; EIMERIA; HUMAN; INTESTINE FLORA; INTESTINE INFECTION; MICROSPORUM; PRIORITY JOURNAL; PROTOZOAL INFECTION; REVIEW; SPOROGENESIS;

EID: 0030065856     PISSN: 00034819     EISSN: None     Source Type: Journal    
DOI: 10.7326/0003-4819-124-4-199602150-00008     Document Type: Review

References (170)

1. Current WL, Garcia LS. Cryptospondiosis. Clin Microbiol Rev. 1991;4 325-58
2. Ortega YR. Sterling CR, Gilman RH, Cama VA, Diaz F. Cyclospora species - a new protozoan pathogen of humans. N Engl J Med. 1993;328: 1308-12
3. Pape JW, Verdier RI, Boncy M, Boncy J, Johnson WD Jr. Cyclospora infection in adults infected with HIV Clinical manifestations, treatment; and prophylaxis Ann Intern Med 1994,121 654-7.
4. Weber R, Bryan RT, Schwartz DA, Owen RL. Human microsporidial infections Clin Microbiol Rev 1994;7 426-61
5. Pape JW, Johnson WD Jr. Isospora belli infections Prog Clin Parasitol. 1991,2 119-27
6. Wurtz R. Cyclospora: a newly identified intestinal pathogen of humans Clin Infect Dis 1994;18 620-3.
7. Casemore DP, Sands RL, Curry A. Cryptosporidium species: a "new" human pathogen J Clin Pathol 1985,38:1321-36.
8. Desportes I, Le Charpentier Y, Galian A, Bernard F, Cochand-Priollet B, Lavergne A. et al. Occurrence of a new micrasporidian: Enterocytozoon bieneusi n g , n. sp. in the enterocytes of a human patient with AIDS. J Protozool 1985,32 250-4.
9. Field AS, Hing MC, Milliken ST, Marriott DJ. Microsporidia in the small intestine of HIV-infected patients A new diagnostic technique and a new species Med J Aust 1993,158 390-4
10. Topazian M, Bia FJ. New parasites on the block emerging intestinal protozoa Gastroenterologist. 1994;2.147-59
11. Jeffrey G. Epidemiologic considerations of isosporiasis in a school for mental defectives The American Journal of Hygiene 1958,67 251-5.
12. Henderson H, Gillespie G, Kaplan P, Steber M. The human isospora Am J Hyg 1963,78 302-9
13. Faust E, Giraldo L, Caciedo G, Bonfante R. Human isosporiasis in the Western hemisphere Am J Trop Med Hyg. 1961;10.343-50.
14. Trier JS, Moxey PC, Schimmel EM, Robles E. Chronic intestinal coccidiosis in man intestinal morphology and response to treatment. Gastroenterology 1974,66:923-35
15. Brandborg LL, Goldberg SB, Breidenbach WC. Human cocadiosis - a possible cause of malabsorption N Engl J Med 1970;283 1306-13.
16. Nime FA, Burek JD, Page DL, Holscher MA, Yardley JH. Acute enterocolitis in a human being infected with the protozoan Cryptosporidium. Gastroenterology. 1975,70 592-8
17. Meisel JL, Perera DR, Meligro C, Rubin CE. Overwhelming watery diarrhea associated with a cryptosporidium in an immunosuppressed patient. Gastroenterology 1976,70 1156-60
18. Sterling C, Ortega Y. Cyanobacterium-like cyclospora species [Letter] N Engl J Med 1993,329 1505
19. Ashford RW. Occurrence of an undesenbed coccidian in man in Papua New Guinea Ann Trop Med Parasitol 1979,73:497-500
20. Dobbins WO 3d, Weinstein WM. Electron microscopy of the intestine and rectum in acquired immunodeficiency syndrome. Gastroenterology 1985, 88 738-49
21. Modigliani R, Bories C, Le Charpentier Y, Salmeron M, Messing B, Galian A, et al. Diarrhea and malabsorption in acquired immune deficiency syndrome, a study of four cases with special emphasis on opportunistic protozoan infections Gut 1985,26 179-87.
22. Cali A, Kotler DP, Orenstein JM. Septata intestinalis N G, N Sp , an intestinal microsporidian associated with chronic diarrhea and dissemination in AIDS patients J Eukaryot Microbiol. 1993,40 101-12.
23. Soave R, Dubey JP, Ramos LJ, Tummings M. A new intestinal pathogen? [Abstract] Clin Res 1986:34 533A
24. Long EG, Ebrahimzadeh A, White EH, Swisher B, Callaway CS. Alga associated with diarrhea in patients with acquired immunodeficiency syndrome and in travelers J Clin Microbiol 1990,28.1101-4.
25. Outbreaks of diarrheal illness associated with cyanobacteria (blue-green algae)-iike bodies - Chicago and Nepal, 1989 and 1990 MMWR Morb Mortal Wkly Rep 1991,40.325-7.
26. Wittner M, Tanowitz HB, Weiss LM. Parasitic infections in AIDS patients Cryptosporidiosis, isosporiasis, microsporidiosis, cyclosporiasis Infect Dis Clin North Am 1993,7:569-86
27. Petersen C, Cryptosporidiosis in patients infected with the human immunodeficiency virus J Infect Dis. 1993,15:903-9.
28. DeHovitz JA, Pape JW, Boncy M, Johnson WD Jr. Clinical manifestations and therapy of isospora belli infection in patients with the acquired immunodeficiency syndrome N Engl J Med. 1986,315:87-90.
29. Weber R, Bryan RT. Microsporidial infections in immunodeficient and immunocompetent patients. Clin Infect Dis. 1994;19:517-21
30. Sandfort J. Hannemann A, Gelderblom H, Stark K, Owen RL, Ruf B. Enterocytozoon bieneusi infection in an immunocompetent patient who had acute diarrhea and who was not infected with the human immunodeficiency virus Clin Infect Dis 1994,19 514-6.
31. Sleigh M. The nature of protozoa In Kreier JP, Baker JR, eds. Parasitic Protozoa. 2d ed v 1. San Diego Academic Pr; 1992 1-53
32. Shadduck JA, Orenstein JM. Comparative pathology of microsporidiosis. Arch Pathol Lab Med. 1993;117 1215-9
33. Bryan RT, Weber R. Microsporidia Emerging pathogens in immunodeficient persons [Editorial] Arch Pathol Lab Med. 1993,117 1243-5.
34. Johnston AM. Veterinary sources of foodborne illness. Lancet. 1990,336: 856-8
35. Fang G, Araujo V, Guerrant R. Enteric infections associated with exposure to animals or animal products Infect Dis Clin North Am. 1991,5 681-701
36. Molbak K, Aaby P, Hojlyng N, da Silva AP. Risk factors for Cryptosporidium diarrhea in early childhood: a case-control study from Guinea-Bissau, West Africa Am J Epidemiol 1994,139:734-40
37. Kirkpatrick CE. Animal reservoirs of Cryptospondium spp and isospora belli [Letter] J Infect Dis. 1988;158 909-10
38. Glaser CA, Angulo FJ, Rooney JA. Animal-associated opportunistic infections among persons infected with the human immunodeficiency virus Clin Infect Dis. 1994,18:14-24.
39. Addressing emerging infectious disease threats. a prevention strategy for the United States Executive summary MMWR Morb Mortal Wkly Rep 1994; 43(RR-5):1-18
40. Hoge CW, Shlim DR, Rajah R, Triplett J, Shear M, Rabold JG, et al. Epidemiology of diarrheal illness associated with coccidian-like organism among travellers and foreign residents in Nepal Lancet. 1993;341:175-9
41. Mac Kenzie WR, Hoxie NJ, Proctor ME, Gradus MS, Blair KA, Peterson DE, et al. A massive outbreak in Milwaukee of cryptosporidium infection transmitted through the public water supply. N Engl J Med 1994;331: 161-7
42. Sterling C, Arrowood M. Cryptosporidia In: Kreier JP, Baker JR, eds. Parasitic Protozoa. 2d ed. v 6. San Diego Academic Pr, 1993 156-225
43. Kuhls TL, Mosier DA, Crawford DL Griffis J. Seroprevalence of cryptosporidial antibodies during infancy, childhood, and adolescence. Clin Infect Dis 1994,18 731-5
44. Newman RD, Zu SX, Wuhib T, Lima AA, Guerrant RL, Sears CL Household epidemiology of Cryptosporidium parvum infection in an urban community in northeast Brazil Ann Intern Med. 1994,120:500-5
45. Current WL Cryptosporidium parvum household transmission [Editorial] Ann Intern Med 1994,120 518-9.
46. Jokipii L, Pohjola S, Jokipii AM. Cryptosporidiosis associated with traveling and giardiasis. Gastroenterology. 1985;89 838-42
47. Ma P, Kaufman D, Helmick CG. Cryptosporidiosis in tourists returning from the Caribbean [Letter] N Engl J Med 1985,312:647-8.
48. Koch KL, Phillips DJ, Aber RC, Current WL. Cryptosporidiosis in hospital personnel. Evidence for person-to-person transmission. Ann Intern Med 1985;102 593-6.
49. Alpert G, Bell LM, Kirkpatrick CE, Budnick LD, Campos JM, Friedman HM, et al. Outbreak of Cryptosporidiosis in a day-care center. Pediatrics 1986,77:152-7.
50. McAnulty JM, Fleming DW, Gonzalez AH. A community-wide outbreak of Cryptosporidiosis associated with swimming at a wave pool JAMA 1994; 272.1597-600
51. Soave R, Johnson WD Jr. Cryptosporidium and teospora belli infections J Infect Dis. 1988,157 225-9
52. Goodgame RW. AIDS in Uganda - clinical and social features N Engl J Med 1990;323 383-9.
53. Huang P, Weber JT, Sosin DM, Griffin PM, Long EG, Murphy JJ, et al. The first reported outbreak of diarrheal illness associated with Cyclospora in the United States Ann Intern Med 1995,123 409-14.
54. Bendall RP, Lucas S, Moody A, Tovey G, Chiodini PL. Diarrhoea associated with cyanobacterium-like bodies a new coccidian enteritis of man Lancet. 1993,341:590-2.
55. Ooi WW, Zimmerman SK, Needham CA. Cyclospora species as a gastrointestinal pathogen in immunocompetent hosts. J Clin Microbiol 1995,33 1267-9
56. Rene E, Marche C, Regnier B, Saimot AG, Vilde JL Perrone C, et al. Intestinal infections in patients with acquired immunodeficiency syndrome. A prospective study in 132 patients. Dig Dis Sci. 1989,34:773-80
57. Laughon BE, Druckman DA, Vernon A, Quinn TC, Polk BF, Modlin JF, et al. Prevalence of enteric pathogens in homosexual men with and without acquired immunodeficiency syndrome Gastroenterology. 1988;94:984-93.
58. Smith PD, Lane HC, Gill VJ, Manischewitz JF, Quinnan GV, Fauci AS, et al. Intestinal infections in patients with the acquired immunodeficiency syndrome (AIDS) Etiology and response to therapy. Ann Intern Med 1988, 108 328-33
59. Johanson JF, Sonnenberg A. Efficient management of diarrhea in the acquired immunodeficiency syndrome (AIDS) A medical decision analysis Ann Intern Med 1990;112 942-8
60. Malebranche R, Arnoux E, Guerin JM, Pierre GD, Laroche AC, Pean-Guichard C, et al. Acquired immunodeficiency syndrome with severe gastrointestinal manifestations in Haiti Lancet. 1983,1:873-8
61. Sewankambo N, Mugerwa RD, Goodgame R, Carswell JW, Moody A, Lloyd G, et al. Enteropathic AIDS in Uganda An endoscopic, histological and microbiological study AIDS 1987,1.9-13
62. Kotler DP, Orenstein JM. Prevalence of intestinal microsporidiosis in HIV-infected individuals referred for gastroenterologic evaluation Am J Gastroenterol 1994,89 1998-2002
63. Wuhib T, Silva TM, Newman RD, Garcia LS, Pereira ML, Chaves CS, et al. Cryptosporidial and microsporidial infections in human immunodeficiency virus-infected patients in northeastern Brazil J Infect Dis 1994;170 494-7.
64. Cotte L, Rabodonirina M, Piers MA, Perreard M, Mojon M, Trepo C. Prevalence of intestinal protozoans in French patients infected with HIV J Acquir Immune Defic Syndr 1993,6.1024-9
65. Eeftinck Schattenkerk JK, van Gool T, van Ketel RJ, Bartelsman JF, Kuiken CL, Terpstra WJ, et al. Clinical significance of small-intestinal microsporidiosis in HIV-1-infected individuals Lancet 1991;337 895-8
66. Sauda FC, Zamarioli LA, Ebner Filho W, Mello L de B. Prevalence of Cryptosporidium sp. and Isospora belli among AIDS patients attending Santos Reference Center for AIDS, Sao Paulo, Brazil J Parasitol 1993,79.454-6
67. Colebunders R, Lusakumuni K, Nelson AM, Gigase P, Lebughe I, van Marck E, et al. Persistent diarrhoea in Zairian AIDS patients, an endoscopic and histological study Gut 1988,29:1687-91
68. Conlon CP, Pinching AJ, Perera CU, Moody A, Luo NP, Lucas SB. HIV-related enteropathy in Zambia: a clinical, microbiological, and histological study. Am J Trop Med Hyg 1990,42 83-8.
69. Wurtz RM, Kocka FE, Peters CS. Weldon-Linne CM, Kuritza A, Yung-bluth P. Clinical characteristics of seven cases of diarrhea associated with a novel acid-fast organism in the stool. Clin Infect Dis 1993;16:136-8
70. Powell DW. New paradigms for the pathophysiology of infectious diarrhea [Editorial] Gastroenterology 1994,106:1705-7
71. Powell D. Approach to the patient with diarrhea In Yamada T, ed Textbook of Gastroenterology 2d ed Philadelphia JB Lippincott; 1995-820-4
72. Hinterleitner TA, Powell DW. Immune system control of intestinal ion transport. Proc Soc Exp Biol Med. 1991,197.249-60
73. Ciancio MJ, Chang EB. Epithelial secretory response to inflammation Ann N Y Acad Sc 1992;664 210-21
74. MacDonald TT, Spencer J. Evidence that activated mucosal T cells play a role in the pathogenesis of enteropathy in human small intestine J Exp Med 1988,167:1341-9
75. Argenzio RA, Lecce J, Powell DW. Prostanoids inhibit intestinal NaCl absorption in experimental porcine cryptospondiosis. Gastroenterology 1993,104 440-7
76. Argenzio RA, Liacos JA, Levy ML, Meuten DJ, Lecce JG, Powell DW. Villous atrophy, crypt hyperplasia, cellular infiltration, and impaired glucose-Na absorption in enteric cryptosporidiosss of pigs Gastroenterology 1990,98 1129-40.
77. + exchange in experimental porcine cryptosporidiosis Gastroenterology 1994;106.1418-28
78. Guarino A, Canani RB, Pozio E, Terracciano L, Albano F, Mazzeo M. Enterotoxic effect of stool supernatant of Cryptosporidium-infected calves on human jejunum Gastroenterology 1994,106 28-34.
79. Guarino A, Canani RB, Casola A, Pozio E, Russo R, Bruzzese E, et al. Human intestinal cryptosporidiosis: secretory diarrhea and enterotoxic activity in Caco-2 cells J Infect Dis 1995.171:976-83
80. Sears CL, Guerrant RL. Cryptosporidiosis: the complexity of intestinal pathophysiology [Editorial] Gastroenterology 1994,106.252-4
81. Griffiths JK, Moore R, Dooley S, Keusch GT, Tzipori S. Cryptosporidium parvum infection of Caco-2 cell monolayers induces an apical monolayer defect, selectively increases transmonolayer permeability, and causes epithelial cell death Infect Immun 1994,62 4506-14
82. Adams RB, Guerrant RL, Zu S, Fang G, Roche JK. Cryptosporidium parvum infection of intestinal epithelium morphologic and functional studies in an in vitro model J Infect Dis 1994,169.170-7.
83. Goodgame RW, Genta RM, White AC, Chappell CL. Intensity of infection in AIDS-associated cryptosporidiosis. J Infect Dis 1993,167:704-9
84. Genta RM, Chappell CL, White AC Jr, Kimball KT, Goodgame RW. Duodenal morphology and intensity of infection in AIDS-related intestinal cryptosporidiosis Gastroenterology 1993,105.1769-75
85. Goodgame RW, Kimball K, Ou CN, White AC Jr, Genta RM, Lifschitz CH, et al. Intestinal function and injury in acquired immunodeficiency syndrome-related cryptosporidiosis Gastroenterology 1995:108 1075-82
86. Connor BA, Shlim DR, Scholes JV, Rayburn JL, Reidy J, Rajah R. Pathologic changes in the small bowel in nine patients with diarrhea associated with a coccidia-like body Ann Intern Med 1993,119:377-82.
87. Orenstein JM, Chiang J, Steinberg W, Smith PD, Rotterdam H, Kotler DP. Intestinal microsporidiosis as a cause of diarrhea in human immunodeficiency virus-infected patients a report of 20 cases Hum Pathol 1990,21 475-81
88. Orenstein JM, Tenner M, Cali A, Kotler DP. A microsporidian previously undescribed in humans, infecting enterocytes and macrophages, and associated with diarrhea in an acquired immunodeficiency syndrome patient Hum Pathol. 1992,23.722-8.
89. Orenstein JM. Microsporidiosis in the acquired immunodeficiency syndrome J Parasitol 1991,77:843-64
90. Bird RG, Smith MD. Cryptosporidiosis in man parasite life cycle and fine structural pathology. J Pathol 1980,132 217-33
91. Shlim DR, Cohen MT, Eaton M, Rajah R, Long EG, Ungar BL. An alga-like organism associated with an outbreak of prolonged diarrhea among foreigners in Nepal Am J Trop Med Hyg. 1991,45:383-9
92. Kotler DP, Francisco A, Clayton F, Scholes JV, Orenstein JM. Small intestinal injury and parasitic diseases in AIDS Ann Intern Med 1990,113 444-9
93. Kotler DP, Reka S, Chow K, Orenstein JM. Effects of enteric parasitoses and HIV infection upon small intestinal structure and function in patients with AIDS J Clin Gastroenterol 1993,16.10-5
94. Kapembwa MS, Bridges C, Joseph AE, Fleming SC, Batman P. Griffin GE. Ileal and jejunal absorptive function in patients with AIDS and enterococcidial infection. J Infect. 1990,21:43-53.
95. Reese NC, Current WL Ernst JV, Bailey WS. Cryptosporidiosis of man and calf: a case report and results of experimental infections in mice and rats Am J Trop Med Hyg. 1982;31:226-9.
96. Molbak K, Lisse IM, Hojlyng N, Aaby P. Severe cryptosporidiosis in Children with normal T-cell subsets Parasite Immunol 1994,16 75-7
97. Jacyna MR, Parkin J, Goldin R, Baron JH. Protracted enteric oyptosporidial infection in selective immunoglobulin A and saccharomyces opsonin deficiencies. Gut. 1990;31:714-6.
98. Ungar BL Soave R, Fayer R, Nash TE. Enzyme immunoassay detection of immunoglobulin M and G antibodies to Cryptosporidium in immunocompetent and immunocompromised persons J Infect Dis 1986;153.570-8.
99. Laxer MA, Alcantara AK, Javato-Laxer M, Menorca DM, Fernando MT, Ranoa CP. Immune response to Cryptosporidiosis in Philippine children Am J Trop Med Hyg. 1990,42:131-9.
100. Ungar BL, Gilman RH, Lanata CF, Perez-Schael I. Seroepidemiology of Cryptosporidium infection in two Latin American populations J Infect Dis 1988,157.551-7.
101. Ungar BL, Mulligan M, Nutman TB. Serologic evidence of Cryptosporidium infection in US Volunteers before and during Peace Corps service in Africa. Arch Intern Med. 1989,149:894-7.
102. Mead JR, Arrowood MJ, Sterling CR. Antigens of Cryptosporidium sporozoites recognized by immune sera of infected animals and humans J Parasitol. 1988,74:135-43.
103. Gomez Morales MA, Pozio E, Croppo GP. Serodiagnosis of cryptosporidiosis in Italian HIV-positive patients by means of an oocyst antigen in an ELISA J Infect. 1992,25:229-36
104. Tzipori S, Roberton D, Chapman C. Remission of diarrhoea due to cryptosporidiosis in an immunodeficient child treated with hyperimmune bovine colostrum. Br Med J (Clin Res Ed). 1986,293 1276-7
105. Lasser KH, Lewin KJ, Ryning FW. Cryptosporidial enteritis in a patient with congenital hypogammaglobulinemia. Hum Pathol 1979;10:234-40.
106. Sloper KS, Dourmashkin RR, Bird RB, Slavin G, Webster AD. Chronic malabsorption due to Cryptosporidiosis in a child with immunoglobulin deficiency Gut 1982;23:80-2
107. Weisburger WR, Hutcheon DF, Yardley JH, Roche JC, Hillis WD, Charache P. Cryptosporidiosis in an immunosuppressed renal-transplant recipient with IgA deficiency Am J Clin Pathol. 1979:72 473-8
108. Cozon G, Biron F, Jeannin M, Cannella D, Revillard JP. Secretory IgA antibodies to Gyptosporidium parvum in AIDS patients with chronic Cryptosporidiosis. J Infect Dis 1994,169 696-9
109. Crowe SM, Carlin JB, Stewart KI, Lucas CR, Hoy JF. Predictive value of CD4 lymphocyte numbers for the development of opportunistic infections and malignancies in HIV-infected persons. J Acquir Immun Defic Syndr 1991,4 770-6
110. Gomez Morales MA, Ausiello CM, Urbani F, Pozio E. Crude extract and recombinant protein of Cryptosporidium parvum oocysts induce proliferation of human peripheral blood mononuclear cells in vitro J Infect Dis 1995; 172 211-6.
111. Flanigan T, Whalen C, Turner J, Soave R, Toerner J, Havlir D, et al. Cryptosporidium infection and CD4 counts Ann Intern Med. 1992;116: 840-2
112. Connolly GM, Dryden MS, Shanson DC, Gazzard BG. Cryptosporidial diarrhea in AIDS and its treatment Gut 1988;29:593-7
113. Sogni P. Treatment of intestinal Cryptosporidiosis in AIDS [Letter] Gastroenterology 1990,99 602-3
114. Chandrasekar PH. Cure of chronic Cryptosporidiosis during treatment with azidothymidine in a patient with acquired immune deficiency syndrome [Letter] Am J Med 1987,83:187
115. Greenberg RE, Mir R, Bank S, Siegal FP. Resolution of intestinal cryptosporidiosis diarrhea after treatment of AIDS with A2T. Gastroenterology 1989;98:1327-30.
116. Current WL, Reese NC, Ernst JV, Bailey WS, Heyman MB, Weinstein WM. Human cryptosporidiosis in immunocompetent and irnmunodeficient persons. Studies of an outbreak and experimental transmission N Engl J Med 1983,308:1252-7
117. D'Antonio RG, Win RE, Taylor JP, Gustafson TL, Current WL, Rhodes MM, et al. A waterborne outbreak of Cryptosporidiosis in normal hosts. Ann Intern Med. 1986;103:886-8
118. Fayer R, Ungar BL Cryptosporidium spp and Cryptosporidiosis. Microbiol Rev 1986,50 458-83.
119. Roberts WG, Green PH, Ma J, Carr M, Ginsberg AM. Prevalence of cryptosporidiosis in patients undergoing endoscopy evidence for an asymptomatic carrier state. Am J Med. 1989,87 537-9
120. Vuorio AF, Jokipii AM, Jokipii L. Cryptosporidium in asymptomatic children Rev Infect Dis 1991,13:261-4
121. Soave R, Ma P. Cryptosporidiosis. Traveler's diarrhea in two families Arch Intern Med 1985,145 70-2.
122. Janoff EN, Limas C, Gebhard RL, Penley KA. Cryptosporidial carriage without symptoms in the acquired immunodeficiency syndrome (AIDS) [Letter] Ann Intern Med 1990;112.75-6
123. Zar F, Geiseler PJ, Brown VA. Asymptomatic carriage of cryptosporidium in the stool of a patient with acquired immunodeficiency syndrome [Letter]. J Infect Dis. 1985,151.195
124. Blanshard C, Jackson AM, Shanson DC, Francis N, Gazzard BG. Cryptosporidiosis in HIV-seropositive patients. Q J Med. 1992,85:813-23.
125. Rabeneck L, Gyorkey F, Genta RM, Gyorkey P, Foote LW. Risser JM. The role of Microsporidia in the pathogenesis of HIV-related chronic diarrhea Ann Intern Med. 1993;119:895-9.
126. Orenstein JM, Benator D, Kotler DP. Microsporidia and HIV-related diarrhea [Letter]. Ann Intern Med. 1994;120.973-4.
127. Rabeneck L, Genta R. Microsporidia and HIV-related diarrhea [letter] Ann Intern Med. 1994,120 973-4.
128. Hoge CW, Shlim DR, Echeverria P. Cyanobacterium-like cyclospora species [Letter] N Engl J Med 1993;329.1504-5.
129. Weber R, Bryan RT, Owen RL, Wilcox CM, Gorelkin L, Visvesvara GS. Improved light-microscopical detection of microsporidia spores in stool and duodenal aspirates The Enteric Opportunistic Infections Working Group N Engl J Med. 1992,326.161-6
130. Jokipii L, Jokipii AM. Timing of symptoms and oocyst excretion in human cryptosporidiosis. N Engl J Med 1986;315:1643-7
131. Sallon S, Deckelbaum RJ, Schmid II, Harlap S, Baras M, Spira DT. Cryptospondium, malnutrition, and chronic diarrhea in children Am J Dis Child. 1988;142:312-5
132. Shaffer N, Moore L. Chronic travelers' diarrhea in a normal host due to Isospora bellir [Letter] J Infect Dis 1989;159.596-7
133. Godiwala T, Yaeger R. Isospora and traveler's diarrhea [Letter] Ann Intern Med 1987,106.908-9
134. Miller FH Jr, Pizzuto AV, McCauley H. Human isotoporiasts. two cases Am J Trop Med Hyg. 1971;20:23-5.
135. Wolfson JS, Richter JM, Waldron MA, Weber DJ, McCarthy DM, Hopkins CC. Cryptosporidiosis in immunocompetent patients. N Engl J Med. 1985,312:1278-82
136. Berlin OG, Novak SM, Porschen RK, Long EG, Stelma GN, Schaeffer FW 3d. Recovery of Cyclospora organisms from patents with prolonged diarrhea Clin Infect Dis. 1994,18:606-9.
137. Hoge CW, Shlim DR, Ghimire M, Rabold JG, Pandey P, Walch A. et al. Placebo-controlled trial of co-trimoxazole for cyclospora infections among travellers and foreign residents in Nepal. Lancet. 1995,345 691-3.
138. Peng CY, Tsai W. Isospora belli infection in a patient with Hodgkin's disease report of a case. J Formos Med Assoc. 1991,90.260-3
139. Westerman EL, Christensen RP. Chronic Isospora belli infection treated with co-trimoxazole. Ann Intern Med 1979;91:413-4.
140. Asmuth DM, DeGirolami PC, Federman M, Ezratty CR, Pleskow DK, Desai G, et al. Clinical features of microsporidiosis in patients with AIDS Clin Infect Dis. 1993,18:819-25
141. Schneiderman DJ, Cello JP, Laing FC. Papillary stenosis and sclerosing cholangitis in the acquired immunodeficiency syndrome Ann Intern Med 1987,106 546-9
142. Benhamou Y, Caumes E, Gerosa Y, Cadrenal JF, Dohin E, Katlama C, et al. AIDS-related cholangiopathy Critical analysis of a prospective series of 26 patients. Dig Dis Sci 1993,38:1113-8.
143. Hinnant K, Schwartz A, Rotterdam H, Rudski C. Cytomegaloviral and cryptosporidial cholecystitis in two patients with AIDS. Am J Surg Pathol. 1989,13 57-60
144. Beaugerie L, Teilhac MF, Deluol AM, Fritsch J, Girard PM, Rozenbaum W, et al. Cholangiopathy associated with Microsporidia infection of the common bile duct mucosa in a patient with HIV infection Ann Intern Med. 1992,117 401-2.
145. Pol S, Romana CA, Richard S, Amouyal P, Desportes-Livage I, Carnot F, et al. Microsporidia infection in patients with the human immunodeficiency virus and unexplained cholangitis. N Engl J Med 1993;328:95-9
146. Willson R, Harrington R, Stewart B, Fritsche T. Human immunodeficiency virus 1-associated necrotizing cholangitis caused by infection with Septara intestinalis Gastroenterology 1995;108:247-51
147. Senator DA, French AL, Beaudet LM, Levy CS, Orenstein JM. Isospora belli infection associated with acalculous cholecystitis in a patient with AIDS Ann Intern Med. 1994;121:663-4.
148. Gross TL, Wheat J, Bartlett M, O'Connor KW. AIDS and multiple system involvement with cryptosporidium Am J Gastroenterol 1986;81:456-8
149. Molina JM, Oksenhendler E, Beauvais B, Sarfati C, Jaccard A, Derouin F, et al. Disseminated microsporidiosis due to Septata intestinalis in patients with AIDS: clinical features and response to albendazole therapy. J Infect Dis. 1995,171 245-9
150. Weber R, Kuster H, Keller R, Bachi T, Spycher MA, Briner J, et al. Pulmonary and intestinal microsporidiosis in a patient with the acquired immunodeficiency syndrome Am Rev Respir Dis. 1992;146:1603-5
151. Garcia LS, Bruckner DA, Brewer TC, Shimizu RY. Techniques for recovery and identification of Cryptosporidium oocysts from stool specimens J Clin Microbiol 1983;18 185-90
152. Madico G, Gilman RH, Miranda E, Cabrera L, Sterling CR. Treatment of cyclospora infections with co-trimoxazole [Letter] Lancet 1993;342. 122-3
153. Arrowood MJ, Sterling CR. Comparison of conventional staining methods and monoclonal antibody-based methods for Cryptosporidium oocyst detection J Clin Microbiol. 1989,27 1490-5
154. Weber R, Bryan RT, Bishop HS, Wahlquist SP, Sullivan JJ, Juranek DD. Threshold of detection of Cryptosporidium oocysts in human stool specimens: evidence for low sensitivity of current diagnostic methods J Clin Microbiol. 1991,29.1323-7
155. Grigoriew GA, Walmsley S, Law L, Chee SL, Yang J, Keystone J, et al. Evaluation of the Merifluor immunofluorescent assay for the detection of Cryptosporidium and Giardia in sodium acetate formalin-fixed stools Diagn Microbiol Infect Dis 1994,19 89-91
156. van Gool T, Snijders F, Reiss P, Eeftinck Schattenkerk JK, van den Bergh Weerman MA, Bartelsman JF, et al. Diagnosis of intestinal and disseminated microsporidial infections in patients with HIV by a new rapid fluorescence technique J Clin Pathol. 1993;46:694-9.
157. Beauvais B, Sarfati C, Molina JM, Lesourd A, Lariviere M, Derouin F. Comparative evaluation of five diagnostic methods for demonstrating microsporidia in stool and intestinal biopsy specimens. Ann Trop Med Parasitol. 1993;87 99-102
158. Gathe J, Piot D, Hawkins K, Bernai A, Clemmons J, Stool F. Treatment of gastrointestinal cryptosporidiosis with paromomycin [Abstract]. In: AIDS in the Nineties: From Science to Policy, San Francisco, California, USA Final Program and Abstracts. San Francisco. Univ of California at San Francisco; 1990.384
159. Clezy K, Gold J, Blaze J, Jones P. Paromomycin for the treatment of cryptosporidial diarrhea in AIDS patients [Letter]. AIDS 1991,5.1146-7.
160. Armitage K, Flanigan T, Carey J, Frank I, MacGregor RR, Ross P, et al. Treatment of cryptosporidiosis with paromomycin. A report of five cases. Arch Intern Med 1992,152:2497-9
161. Fichtenbaum CJ, Ritchie DJ, Powderly WG. Use of paromomycin for treatment of cryptosporidiosis in patients with AIDS. Clin Infect Dis. 1993, 16:298-300.
162. Bissuel F, Cotte L, Rabodonirina M, Rougier P, Piens MA, Trepo C. Paromomycin: an effective treatment for tryptosporidial diarrhea in patients with AIDS Clin Infect Dis 1994,18 447-9
163. Scaglia M, Atzori C, Marchetti G, Orso M, Maserati R, Orani A, et al. Effectiveness of aminosidine (paromomycin) sulfate in chronic Cryptosporidium diarrhea in AIDS patients an open, uncontrolled, prospective clinical trial (Letter) J Infect Dis 1994;170:1349-50.
164. White AC Jr, Chappell CL, Hayat CS, Kimball KT, Flanigan TP, Goodgame RW. Paromomycin for cryptosporidiosis in AIDS: a prospective, double-blind trial J Infect Dis. 1994,170:419-24
165. Pape JW, Verdier RI, Johnson WD Jr. Treatment and prophylaxis of Isospora belli infection in patients with the acquired immunodeficiency syndrome N Engl J Med 1989;320:1044-7
166. Weber R, Sauer B, Spycher MA, Deplazes P, Keller R, Ammann R, et al. Detection of Septata intestinalis in stool specimens, and coprodiagnostic monitoring of successful treatment with albendazole Clin Infect Dis. 1994;19:242-5
167. Dieterich DT, Lew EA, Kotler DP, Poles MA, Orenstein JM. Treatment with albendazole for intestinal disease due to Enterocytozoon bieneusi in patients with AIDS J Infect Dis. 1994:169,178-83
168. Assessing the public health threat associated with waterborne cryptosporidiosis report of a workshop MMWR Morb Mortal Wkly Rep. 1995,44(RR-6): 1-19
169. Cordell RL, Addiss DG. Cryptosporidiosis in child care settings: a review of the literature and recommendations for prevention and control Pediatr Infect Dis J. 1994,13 310-7
170. Juranek DD. Cryptosporidiosis sources of infection and guidelines for prevention Clin Infect Dis. 1995,21(Suppl 1):S57-61.