Isospora

Bismuth subsahcylate [14882-18-9] Pepto-Bismol, is a basic salt of varying composition, corresponding approximately to i9-H0CgH4C02(Bi0). Like a number of other insoluble bismuth preparations, it is not currentiy approved in the United States for the treatment of peptic ulcer disease but is under active investigation for this purpose (180). It does appear to be effective for the rehef of mild diarrhea and for the prevention of travelers diarrhea (181). The ready availabiUty of this dmg, however, may lead to its ovemse and result in toxic effects caused by both the saUcylate and bismuth components. It has been suggested that bismuth subsahcylate is somewhat effective in the symptomatic treatment of isosporiasis, a disease caused by the intracellular parasite Isospora belli (182). 

Note Fecal screening may show other intestinal parasites, including Cryptosporidium spp., Balantidium coii, Dientamoeba fragiiis, Isospora belli, C. lamblia, or Blastocystis hominis. 

Consider parasites Giardia Entamoeba histolytica Strongyloides stercoralis Cryptosporidium Cyclospora Isospora belli ... 

Isospora belli Trimethoprim-sulfamethoxazole, one double-strength tablet 4 times daily for 10 days, then twice daily for 21 days Pyrimethamine, 75 mg daily for 14 days... 

A 32-year-old Haitian man with AIDS developed com-phcations of Isospora belli enteritis (17). He was given intravenous eflomithine and developed severe thrombocytopenia, nausea, and vomiting, which recurred on rechallenge with low-dose oral eflomithine. 

This is a serious parasitic disease of birds, especially poultry, though coccidiosis in cattle, sheep, goats, horses, swine and rarely in humans has also been reported. [52,53], Coccidiosis in domestic fowl is responsible for considerable economic loss [53]. The coccidia are microscopic sporozoa belonging to the genera Eimeria and Isospora. 

Opportunistic infections bacterial (MAI, TB) viral (CMV, herpes) fungal Candida albicans, cryptococcus) protozoal Pneumocystis carinii, microsporidia, Isospora belli, Cryptosporidia, Giardia lamblia) Malignancies Kaposi s sarcoma, lymphoma Medications antibiotics, anticancer chemotherapy, antidepressants Neuropsychiatric disorders dementia, depression, anxiety, encephalopathy Socioeconomic factors IV drug abuse, low income... 

Isospora belli Monoxenous (human specific) Yes Yes Male homosexual human-to-human transmission (hypothetical)... 

Most are monoxenous (= one host), a feature which is consistent with an easier spreading. Especially, if human is the specific host, he can play the role of reservoir and of infectious source to other humans or to the environment (e.g. Giardia intestinalis, C. hominis, Cyclospora cayetanensis, Isospora belli). 

Blackburn BG, Mazurek JM, Hlavsa M, Park J, TiHapaw M, Parrish M, Salehi E, Franks W, Koch E, Smith F, Xiao L, Arrowood M, Hill V, da Silva A, Johnston S, Jones JL (2006) Cryptosporidiosis associated with ozonated apple cider. Emerg Infect Dis 12 684-686 Bonnin A, Dei-Cas E, Camerlynck P (1992) Cryptosporidium and Isospora. In Myint S, Cann A (eds) Molecular and cell biology of opportunistic infections in AIDS. Chapman HaU, London... 

Borst, P., Overdulve, J. P., Weijers, P. J., Fase-Fowler, F., and Van den Berg, M. (1984). DNA circles with cruciforms from Isospora (Toxoplasma) gondii. Biochim. Biophys. Acta 781, 100-111. 

Caused by Isospora belli, an intracellular coccidial protozoan. 

Nocardia infections have been treated successjully, but failures also have been reported. Although a combination of doxycycline and streptomycin or gentamicin is considered the treatment of choice for brucellosis, trimethoprim—sulfamethoxazole may be an effective substitute for the doxy-cyctine combination. Trimethoprim—sulfamethoxazole also has been used successjully for Whipple s disease, Stenotrophomonas maltophilia infection, and infection by the intestinal parasites Cyclospora and Isospora. 

Clinical use TMP-SMZ is the first choice in prophylaxis and treatment of pneumocystis pneumonia (PCP). Prophylaxis in AIDS patients is recommended when the CD4 count drops below 200 cells/pL. Oral treatment with the double-strength formulation three times weekly is usually effective. The same regimen of TMP-SMZ is prophylactic against toxoplasmosis and infections due to Isospora belli. For treatment of active PCP. daily oral or intravenous administration of TMP-SMZ is required. 

G. Altreuther, N. Gasda, K. Adler, K. Hellmann, H. Thurieau, A. Schimmel, D. Hutchens and K. J. Krieger, Field evaluations of the efficacy and safety of emodepside plus toltrazuril (Procox oral suspension for dogs) against naturally acquired nematode and Isospora spp. infections in dogs, Parasitol. Res., 2011, 109(Suppl. 1), S21-S28. 

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