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Acta Parasitologica

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Volume 62, Issue 3 (Sep 2017)

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Intestinal coccidian parasites as an underestimated cause of travellers’ diarrhoea in Polish immunocompetent patients

Matylda Kłudkowska
  • Corresponding author
  • Department and Clinic of Tropical and Parasitic Diseases, Poznań University of Medical Sciences, Poznań, Poland
  • Division of Parasitology, Central Laboratory of Microbiology, H. Święcicki University Hospital, Poznań, Poland
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Łukasz Pielok
  • Department and Clinic of Tropical and Parasitic Diseases, Poznań University of Medical Sciences, Poznań, Poland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Krystyna Frąckowiak
  • Division of Parasitology, Central Laboratory of Microbiology, H. Święcicki University Hospital, Poznań, Poland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Małgorzata Paul
  • Department and Clinic of Tropical and Parasitic Diseases, Poznań University of Medical Sciences, Poznań, Poland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-07-05 | DOI: https://doi.org/10.1515/ap-2017-0077

Abstract

Intestinal coccidian parasites are intracellular protozoa most frequently transmitted during food-borne and water-borne infections. This group of parasites is responsible for acute diarrhoeal illnesses especially among immunocompromised patients. However, they are more frequently detected in immunocompetent individuals including travellers, and they should also be considered as important etiologic factors of travellers’ diarrhoea. We examined 221 immunocompetent patients hospitalized due to acute or chronic diarrhoea and other gastrointestinal symptoms after returning from international journeys to hot climates. A basic microscopical examination and acid – fast staining of stool samples was performed. Each patient was also a part of the epidemiological investigation to define potential risk factors of tropical gastrointestinal infections. Intestinal coccidiosis was confirmed in 12 out of 221 successively hospitalized patients (5.4%). The most common coccidian parasite was Cryptosporidium spp., detected in nine Polish travellers (4.1%). Cyclospora spp. was diagnosed in three cases (1.4%), including two mixed infections with Cryptosporidium spp., and Cystoisospora spp. in two other cases (0.9%). The study has revealed that intestinal coccidian parasites are a significant threat to immunocompetent travellers and should be always considered in the differential diagnosis of gastrointestinal disorders. Therefore, it is necessary to perform specialized diagnostic methods for the detection of Cryptosporidium spp., Cystoisospora spp., and Cyclospora spp. oocysts in reference parasitology laboratories. Clinical observations demonstrated simultaneously an insufficient level of knowledge in Polish tourists concerning the main risk factors of intestinal parasitic diseases during international travels, particularly to developing countries with lower economic and sanitary conditions.

Keywords: Cryptosporidiosis; cyclosporiasis; cystoisosporiasis; intestinal coccidiosis; travellers’ diarrhoea

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About the article

Received: 2017-02-09

Revised: 2017-04-26

Accepted: 2017-05-09

Published Online: 2017-07-05

Published in Print: 2017-09-26


Citation Information: Acta Parasitologica, ISSN (Online) 1896-1851, ISSN (Print) 1230-2821, DOI: https://doi.org/10.1515/ap-2017-0077.

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