Opportunistic intestinal protozoal infections in immunocompromised children

ABSTRACT

One hundred immunocompromised children and 100 house contact controls were chosen for this study. Patients included 52 nephrotic syndrome children receiving corticosteroids for more than one month [age 5.28 +/- 2.32 years], 14 protein-calorie malnutrition [PCM] patients [8 cases of marasmus aged 6 +/- 2.27 months and 6 cases of marasmic kwashiorkor aged 1.39 +/- 0.88 years] and 34 lymphomas patients [22 cases of Hodgkin's disease and 12 cases of non-Hodgkin's lymphoma aged 4.5 +/- 3.54 years]. Examination of concentrated stool was done using iodine stain of fresh mounts and modified Ziehl-Neelsen [cold acid-fast] to fixed smears. T-cell subsets were counted after staining with mouse monoclonal antibodies against CD4 and CD8 labeled with fluorescein. Both nephrotic syndrome and lymphomas groups showed affection of cellular immunity in the form of significant decrease in T-helper and H/S ratio and significant increase in suppressor T-cell subsets. Giardia lamblia, Entamoeba histolytica, Cryptosporidium parvum and Blastocystis hominis were the most frequent in patients group and were significantly more prevalent among patients than controls. No significant difference in the prevalence of Entamoeba coli and Chylomastix mesnili between the two groups was observed. C. Parvum infection was strictly confined to groups with T-cell subsets abnormalities [i.e. nephrotic syndrome and lymphomas groups]