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Protozoan infections.

Protozoan infections, against which immunity is predominantly T cell mediated, are likely to be more severe in patients with the acquired immune deficiency syndrome (AIDS) than in immunocompetent hosts. Leishmaniasis, toxoplasmosis and cryptosporidiosis are examples, the last two being particularly common in AIDS patients. Cerebral toxoplasmosis almost always results from recrudescence of latent infections acquired earlier in life. Depletion of T-helper (CD4+) lymphocytes enables bradyzoites to survive if released from cysts in the brain of patients. In the absence of immune pressure bradyzoites revert to tachyzoites and multiply to cause a rapidly developing, necrotizing encephalitis which needs immediate treatment. AIDS patients, especially those who are negative for antibodies to Toxoplasma, should avoid cats, the source of oocysts, and undercooked meat which may contain tissue cysts, as primary infections may become systemic. Cryptosporidium infections are more likely to be primary infections. Sources of infection are other people, farm animals and pets and there is a significant risk from contaminated domestic water supplies. As infections cause a life-threatening secretory diarrhoea in AIDS patients, for which there is not satisfactory treatment at present, such patients should take steps to minimize the risk of infection.

Acquired Immunodeficiency Syndrome↗

Treatment of protozoan infections.

Protozoan infections can have a variety of different cutaneous manifestations in addition to systemic signs and symptoms of disease. Recognition and diagnosis can be difficult, as additional laboratory tests, in addition to biopsies, may be required. Treatment options for different protozoa vary and resolution of disease may be refractory despite lengthy treatment courses. An overview of cutaneous manifestations, diagnosis, and treatment regimen of amebiasis, leishmaniasis, trypanosomiasis, and toxoplasmosis is outlined in this article.

Amebiasis↗

[Parasitic infections in pregnancy and congenital protozoan infections. Part I.: Protozoan infections].

Intestinal protozoan disease diagnosed in pregnancy is mostly controlled by symptomatic treatment. Specific therapy can be delayed until after delivery. Only severe cases, i.e. continued diarrhea leading to malnutrition of either mother or fetus, require an immediate specific drug therapy, which might be harmful to the fetus due to toxic and teratogenic potentials. Vertical transmission of intestinal protozoa has not been described. Invasive protozoan infections can be lethal to the mother making immediate drug therapy mandatory, even if the potentials of fetotoxicity or teratogenicity are known. Vertical transmission occurs independent of maternal symptoms, causing clinical disease in the child either directly after birth or during the first months of life. The knowledge of endemic regions and of the maternal travel history is essential for early diagnosis and treatment of protozoan disease in pregnancy and of congenital protozoan infections.

Adult↗

Emerging human protozoan infections in the temperate European climate.

There has been a resurgence of interest in medical protozoology in the last twenty years or so mainly as a result of the recognition of HIV infection and the opportunistic protozoan infections associated with it. Many new species of microsporidia have been recognised as parasites causing human disease and several rare infections, such as isosporiasis, have become more commonly recognised, even in temperate climates. Some of the infections seen in temperate regions have arrived through foreign travel (tourism, work or immigration), sometimes exacerbated by immunosuppression (due to HIV, organ transplantation or malignancy). Importation of food from around the world and climate change (global warming) may also be contributing to the increase in previously rare protozoan infections now being seen in temperate regions. This article reviews the current status of these new and re-emerging human protozoan infections in temperate, rather than tropical locations.

Climate↗

Protozoan infection in the perinatal period.

Protozoan infections represent an area of concern for advanced practice nurses, particularly those working in rural areas or urban environments with refugee populations and those caring for patients with immunodeficiency-related diseases. Some of these infections have major effects on the fetus and neonate yet pose minimal problems to the mother. Protozoan infections are increasing in prevalence because of poor sanitation, overcrowding, increased foreign travel, and high-risk sexual behaviors. There is a need for public education to promote awareness and prevention of such infections. This emerging public health problem has been reported sporadically in the medical and perinatal nursing literature. This paucity of information may be partly due to the difficulty in diagnosing and managing these infections in the perinatal patient. The article discusses the more common infections caused by protozoa, amebae, and sporozoa: trichomoniasis, giardiasis, amebiasis, and toxoplasmosis.

Female↗

Intestinal protozoan infections and echinococcosis in the inhabitants of Dornod and Selenge, Mongolia (2003).

The status of intestinal parasitic infections and seroprevalence of cystic echinococcosis in the inhabitants in Dornod and Selenge, Mongolia, was observed with stool and serum samples from 165 and 683 residents from August 9 to August 15, 2003. A total of 10 inhabitants (6.1%) were found to be infected with protozoan cysts or oocysts by stool examinations; 7, 1 and 2 cases with Entamoeba coli, Giardia lamblia and Cryptosporidium parvum, respectively. A total of 62 people (9.1%) revealed significantly high levels of specific antibodies against Echinococcus granulosus by enzyme-linked immunosorbent assay (ELISA). The surveyed areas are rural areas and the sanitized tab water is not available. There is a possibility of endemic transmission of water-borne protozoan diseases in these areas. The clinical echinococcosis is needed to be searched from the seropositive inhabitants.

Animals↗

Protozoan infections in the male genital tract.

PURPOSE: We reviewed the literature on protozoan infections in the male genital tract, with special reference to histopathological findings and their repercussions on different andrological functions. MATERIALS AND METHODS: A literature search of the MEDLINE data base from 1966 to May 1995 was done and related articles were identified. The considered terms were parasitology and the male genital organs. Additional searches on infertility, semen and sexually transmitted diseases were performed. RESULTS: Protozoan infections of the male genital tract are rare and only a few species of parasites are involved. Trichomonas vaginalis, Trypanosoma species, Leishmania donovani, Entamoeba histolytica, Acanthamoeba species, Toxoplasma gondii and Plasmodium falciparum have been described in the male genital tract as producing testicular damage or secondary hypogonadism via hypothalamic-hypophyseal axis alterations. CONCLUSIONS: Topics of interest were the role of sexual transmission by some parasites, principally T. vaginalis, relationship with subfertility or infertility in the male subject, clinical significance in differential diagnosis with other inflammatory processes, and for some parasites the relationship with opportunistic behavior and immunodeficiency syndromes, including the acquired immunodeficiency syndrome.

Genital Diseases, Male↗