Ganoderma lucidum: a cause of pseudoparasitosis.

We report a pseudoparasitosis case due to Ganoderma lucidum, (lingzhi or reishi mushroom); we believe this to be a first reported case in Thailand. A 49-year-old male patient with non-Hodgkins lymphoma presented with chronic watery diarrhea. He had a history of consumption of powdered lingzhi extract as a dietary supplement and herbal medicine. Stool examination demonstrated many spores of G. lucidum, which must be differentiated from intestinal helminth ova and coccidia. After discontinuation of mushroom spores ingestion, the diarrheal symptoms improved and fecal examination subsequently showed no Ganoderma spores. Many artifacts in the stool may be confused with parasites. Differentiation of parasites from artifacts depends on characterization of the size, shape, structure, and reactivity with common stains.

Intestinal microsporidiosis in HIV-infected children with diarrhea.

Intestinal microsporidiosis is a common opportunistic disease associated with diarrhea in adult AIDS patients in Thailand; the data regarding this infection in children are scarce. The present study was designed to investigate the prevalence and clinical features of intestinal microsporidiosis in hospitalized HIV-infected and uninfected (free of HIV) children with diarrhea. Of the 95 HIV-infected children and 87 uninfected children, 24 (25.3%) and 13 (14.9%) respectively were diagnosed with intestinal microsporidiosis. Species identification of microsporidia spores, by transmission electron microscopy, demonstrated Enterocytozoon bieneusi in 5 cases. Cryptosporidium parvum was a common coinfective parasite; pneumonia was the most frequent concurrent disease found in children with intestinal microsporidiosis. Malnutrition was commoner in the HIV-infected group (79.2% vs 23.1%; p = 0.003). This study indicates that intestinal microsporidiosis is an important disease in both HIV-infected and uninfected Thai children with diarrhea.

Prevalence of parasitic infections in Thai workers from 1993 to 1997.

Study on the prevalence of parasitic infections in Thai laborers who applied for working abroad was carried out during 5 years. The total number of 78,240 stool specimens was obtained and examined by simple smear and iodine. It was found that the prevalence of parasitic infections from 1993 to 1997 was 12.15%, 13.13%, 12.57%, 4.62% and 5.76% respectively. The five most frequently parasites found in stool were Blastocystis hominis, hookworms, Giardia lamblia, Strongyloides stercoralis and Opisthorchis viverrini. Such findings were similar to previous reports, but in lower percentages. Thus, continuity of public health education and sanitation improvement should be concerned for prevention and control of parasitic infections.

Intestinal parasitic infections in HIV and non-HIV infected patients with chronic diarrhea in Thailand.

Chronic diarrhea is a common problem in AIDS patients, and enteric parasites are re-cognized as important causes. This study determined the prevalence of parasitic infections in HIV infected patients with chronic diarrhea. Ninety-one patients with AIDS who presented with chronic diarrhea and 103 patients who were HIV negative were enrolled in the study. Detection of stool parasites was made by microscopy of simple smear, formalin-ether concentration method, modified acid-fast and modified trichrome staining techniques. Species identification of microsporidia spores was made by transmission electron microscopy (TEM). Cases in which serial fecal examinations were negative were subjected to gastroduodenoscopy and/or colonoscopy. Parasitic infections were found in 51 (56%) AIDS patients with chronic diarrhea and in 18 (17%) non-HIV cases (p < 0.001). Microsporidia and Cryptosporidium parvum were the most common parasites found in HIV infected patients and were also significantly more prevalent than in non-HIV infected cases [29% vs 0% for microsporidia, (p < 0.001), and 25% vs 1% for C. parvum, (p < 0.001)]. Species identification of microsporidia spores in 26 patients using TEM revealed Enterocytozoon bieneusi in 19 cases. This study indicated that microsporidia and C. parvum are important pathogenic causes of chronic diarrhea in AIDS patients in Thailand.

Prevelence of intestinal parasitic infection in children and monks in Bangkok, saraburi and nakhon pathom.

From 1983 to 1986, the authors surveyed for intestinal parasites in four groups of people. In the first group of 474 elementary school children in Bangkok aged 6-15 years, parasites were found in31.2 percent of the specimens examined, the highest prevalence of helminthes being hookworm and Ascaris lumbricoides, i.e. 9.2 and 7.5 percent, respectively; in the second group of 202 monks in Bangkok aged 10-77 years, intestinal parasites were observed in 19.8 percent of the cases, the findings bring hookworm (20.8%) and Strongyloides stercoralis (14.6%); in the third group of 308 monks in Saraburi province aged 10-67 years, intestinal parasites were detected in 60.4 percent of the cases, the finding being hookworm (36.5%) and Opisthorchis viverrini (36.1%); and in the fourth group of 459 monks in Nakorn Pathom province aged 13-35 years, intestinal parasites were found in 53.6 percent of the cases, the finding being Opisthorchis viverrini (32.7%) and hookworm (28.1%) in the firsts group; and Blastocystis hominis (22.9%, 6.9% and 10.6%); Entamoeba coli (12.5%, 6.2% and 8.0%) in the second, third and fourth groups, respectively.