Investigation of intestinal parasites in dialysis patients

To search for the opportunistic and other pathogenic intestinal parasites in dialysis patients, and to compare the methods used for diagnosis. This is a randomized study, which recruited participants from dialysis patients. The study was carried out in the Department of Microbiology, Research Hospital, School of Medicine in Kocaeli University, Kocaeli, Turkey between June 2012 and March 2013. One hundred and forty-two patients were diagnosed with an end-stage renal failure, which underwent dialysis, and 150 healthy volunteers were enrolled to the study. Native-lugol, formol ethyl acetate sedimentation method, trichrome, modified trichrome, acid fast, and Calcofluor staining methods were applied to the stool samples. For the diagnosis of Cryptosporidium spp., Giardia intestinalis [G. intestinalis], and Entamoeba histolytica [E. histolytica], commercially available ELISA kits were used, which detect antigen in the stool. Parasites were found in 62 of the dialysis patients [43.7%] and 19 of the control group [12.7%]. The most encountered parasitic agents in the dialysis patients were Blastocystis spp. [23.9%], G. intestinalis [8.5%], E. histolytica [2.1%], Microsporidia spp. [2.1%], and Cryptosporidium spp. [2.1%]. The parasite detection rate of the formol ethyl acetate sedimentation method was found to be higher than native-lugol [p<0.05]. To protect the dialysis patients with diarrhea from parasitic infections, it is important to carry out interval stool examinations with trichrome, modified trichrome, acid fast, and Calcofluor staining methods and the ELISA method that detects antigen in the stool

Spontaneous rupture of a giant diaphragmatic hydatid cyst into the intrapleural space

We report a case of giant diaphragmatic hydatid cyst which ruptured spontaneously into the intrapleural space in a patient with coexistent giant hepatic hydatid cyst. A 62-year-old female was admitted for dyspnea, nausea, vomiting, and right thoracic pain. Clinical findings, laboratory and radiological examinations including multislice computed tomography scan were consistent with the diagnosis of a giant diaphragmatic hydatid cyst which ruptured into the intrapleural space. Surgical intervention was performed through thoracotomy and phrenotomy in a one-stage operation for both cysts. This case shows that hydatid cysts of the diaphragm can rupture into the intrapleural space spontaneously. One-stage operation through thoracotomy may be successful for the surgical intervention for diaphragmatic hydatid cysts with coexistent hepatic cyst