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.