Human infection with Dicrocoelium dendriticum in Turkey

Human dicrocoeliosis is reported sporadically in various parts of the world. We report a case in a 21-year-old male, who had right upper abdominal pain, weight loss, and chronic relapsing watery diarrhea three to four times daily for four weeks. The patient had abdominal tenderness to palpation in the right upper quadrant. Alkaline phosphatase, alanine aminotransferase, and serum immunoglobulin E levels were slightly elevated; all other biochemical and hematological findings were in their normal ranges. The duodenal biopsy samples were normal and an abdominal ultrasonography showed no biliary or hepatic abnormality. Stool microscopy revealed numerous eggs of Dicrocoelium dendriticum. As pseudoparasitosis can result from eating raw, infected animal liver, the patient was given a liver-free diet for three days, to rule out that possibility. Subsequent stool examinations showed eggs in each of the samples indicating that the infection was genuine. The patient was treated with triclabendazole 10 mg/kg in a single dose. Four weeks later, no parasite eggs were detected in the microscopic examination of the stool samples. The patient got better gradually and the symptoms disappeared. Physicians should keep in mind parasitic diseases such as the rarely encountered dicrocoeliosis

Investigation of cryptosporidiosis by enzyme-linked immunosorbent assay and microscopy in children with diarrhea

To investigate the frequency of cryptosporidiosis by enzyme-linked immunosorbent assay [ELISA] and microscopy and its relationship with diarrhea. The study was prospectively performed in the Parasitology Laboratory and Pediatric Outpatient Clinic of the Research Hospital, Yuzuncu Yil University, Van, Turkey between 2004 and 2006. Stool samples were obtained from a total of 2000 children with diarrhea, 870 females, and 1130 males aging 0-15 years as study group, and 100 children of the same age were randomly selected as a control group. The flotation method was firstly carried out for all stool samples in saturated zinc sulfate solution, then staining process by modified acid-fast staining. All samples were also tested for Cryptosporidium parvum antigen by ELISA. Native-Lugol and trichrome staining were used to identify other intestinal parasites. The antigen was determined in 97 [4.9%] of 2000 children by ELISA, however, the oocysts were only seen in 39 children [1.95%] by microscopy. Cryptosporidium spp. were not detected in the control group either by ELISA or by microscopy. We found a significant [p<0.001] relationship between diarrhea and cryptosporidiosis. Other intestinal parasites were detected in 713 [35.7%] of 2000 diarrheic children. Cryptosporidium spp. antigen searching by ELISA in stool samples should be included for diagnosis of the disease in all hospitals