Discussion:
There are two major Cryptosporidium spp. which cause human infections;
C. hominis primarily infects humans and C. parvum infects humans as well
as other animals(3).
Cryptosporidium parvum is a coccidian protozoon that causes diarrhea.
Although, it is self-limiting in immunocompetent people but can be
prolonged and life-threatening in severely immunocompromised such as
those with HIV/AIDS may cause severe, chronic, and possibly fatal
diarrhea and waste(4).
Cryptosporidium spp. infection caused by ingestion of oocysts
which are in contaminated water or food or by direct person-to-person or
animal-to-person contact(5, 6). The parasite mainly develops in the
enterocytes of the small intestine, causing villous atrophy and crypt
hyperplasia in patients with high-intensity infections(7).
The importance of CD4+ T-cell-mediated immune responses in the
resolution of Cryptosporidium spp. infections have been clearly
established. Following ART (antiretroviral therapy) treatment,
AIDS-associated cryptosporidiosis resolves because of restoration of
CD4+ T cells (8-10).
In endoscopy, biopsy of the antrum, bulb of the antrum, and two parts of
the duodenum were performed to determine the direction and pathology.
Section showed gastric and duodenal mucosa with moderate chronic active
inflammation and small (2-5) spherical bodies. Protrude form apex of
mucinous columnar cells of glandular epithelium. These microorganisms
also present on the surface of partially flattened duodenal mucosa with
evidence of chronic active inflammation. These microorganisms are giemsa
and pas positive. Gastric antral and duodenal biopsies: moderate chronic
active gasterodudonitis with cryptosporidiosis. No evidence of dysplasia
or malignancy.
Although, with the widespread use of effective ART, cryptosporidiosis is
no longer threatening as it once was in AIDS patients in developed
countries, but it continues to pose a major threat to AIDS patients in
resource-poor developing countries where ART is not widely available.