Severe Cystoisospora belli Diarrhoea in Post Renal Transplant Patient

Abstract

Cystoisospora belli (C. belli) is an opportunistic protozoal parasite. It is prevalent in tropical and subtropical areas of the world. It is frequently encountered in immunocompromised patients with Acquired Immunodeficiency Syndrome (AIDS) and other immunodeficiency illnesses. Infection usually occurs due to faecal contamination of food and water. Chronic severe watery diarrhoea occurs in C. belli infected patients. C. belli is diagnosed by demonstration of characteristic oocyst in the stool sample. The common methods used for stool examination are wet saline mount, iodine mount, and modified acid fast staining. Although C. belli is distributed worldwide and more prevalent in developing countries, it is hardly reported from India. Most of the cases reported from India are in Human Immunodeficiency Virus (HIV)-positive patients and not many are reported in renal transplant patients. Here, a case of a 27-year-old male post renal transplant patient having severe diarrhoea has been presented. The patient complained of watery diarrhoea off and on for last one month for which he had taken some medicine from his local level but was not relieved. The patient was negative for HIV and was on immunosuppressive drugs. The stool sample of the patient was examined by direct wet mount, iodine mount and acid fast staining. On microscopy, characteristic oocysts of C. belli were detected. The patient was given combination treatment to which he responded well.

Keywords

• chronic diarrhoea
• immunocompromised patients
• oocyst
• protozoal parasite