Detection of cyclospora cayetanensis infections among diarrheal children attending Suez Canal University Hospital

The objective of the present study is to detect the occurrence of Cyclospora cayetanensis among diarrheal children with or without immunosuppressant conditions. Stool samples were collected and examined for identification of the parasite using different concentration methods [Formaline ethely acetate, Potassium hydroxide and Sheather's floatation] and different stains [acid fast, modified Ziehl Neelsen, modified Kinyoun and modified safranin]. Confirmation of the results was performed using autofluorescence technique. Cyclospora oocysts were detected in 19.6% of 230 diarrheal children without immunosuppressant conditions and 34.6% of 230 diarrheal children with immunosuppressant conditions with significant difference between the two groups. Sheather's floatation method was significantly more sensitive than direct smear, FEA and KOH sedimentation methods [with sensitivities of 93.6%, 63.7%, 75.8% and 79.8%, respectively]. Additionally, the modified safranin was the best staining method as it was significantly more sensitive than the acid fast and the modified Ziehl Neelsen staining. On the other hand, no significant differences were found between the acid fast, the modified Ziehl Neelsen or the modified Kinyoun staining. Cyclosporiasis predominated in the age group 1-4 years compared to other age groups. There was a significant association between infection with Cyclospora and low socioeconomic level, living in rural areas and using tap water. Cyclospora was found as a sole parasite in 55 out of 124 [44.4%] infected children. Co-infection with other pathogenic parasites occurred in 69 cases; most commonly Cryptosporidium [30/124]. It was concluded that cyclosporiasis is common among diarrheal children especially if it is associated with immunosuppressant conditions. Feces examination for oocysts using Sheather's floatation and the modified safranin staining are recommended for diagnosis

Prevalence and clinical features of Dientamoeba Fragilis infections in patients suspected to have intestinal parasitic infection

The present study was conducted to determine the prevalence and clinical features of dientamoebiasis in patients presumed to be infected with intestinal parasites. A total of 168 patients were examined for D. fragilis using microscopy [after Wheatley's trichrome staining] and culture [using modified Boeck and Drbohlav's medium] D. fragilis trophozoites were detected in 15 samples [8.9%] examined using trichrome staining and in 50 samples [29.8%] by culture method. Other enteric parasites were common in the study population as 48.8% of patients [82/168] were found harboring intestinal parasites. Blastocystis hominis was the most common, identified in 33.3% [56/168] of the samples. Giardia lamblia was detected in 17.9% [30/168] and E. histolytica/E. dispar in 11.9% [20/168]. The symptoms most frequently encountered were diarrhea, abdominal pain and weight loss and fatigue. Diarrhea and abdominal pain were significantly more frequent in patients with dientamoebiasis compared to non pathogenic cases [P<0.05]. Diarrhea was 38.5% of patients infected with D. fragilis compared to 50% of patients infected with G. lamblia, while abdominal pain was encountered with D. fragilis in 41% compared to 33.3% with G. lamblia. These differences were insignificant [P>0.05]

Microscopic overdiagnosis of intestinal amoebiasis

To determine the misdiagnosis of intestinal amoebiasis associated to microscopic examination of faeces, 50 stool samples of patients infected with Entamoeba histolytica were collected from different Primary Health Care Centers, hospitals and private laboratories in Ismailia G. The samples were examined using Wheatley's trichrome staining technique to differrentiate E. histolytica E. dispar complex from other non-pathogenic intestinal amoebae and multiplex polymerase chain reaction [PCR]. PCR differentiated between the two morphologic identical species [E. histolytica and E. dispar] and had the advantage to save time and resources. E. histolytica was detected in only 5 [10%] samples and in association with E. dispar in 8 [16%] samples. On the other hand, 20 samples [40%] were E. dispar. The other 17 samples were negative. E. coli, E. hartmanni and polymorphs were commonly misdiagnosed as E. histolytica