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Related Experiment Videos

Refractory isosporiasis.

Sonia Malik1, J C Samantaray, Arvind Bagga

  • 1Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

Indian Journal of Pediatrics
|June 24, 2005
PubMed
Summary
This summary is machine-generated.

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A severe case of isosporiasis caused debilitating diarrhea in a two-year-old child with systemic vasculitis on corticosteroids. This infection was unusually resistant to standard cotrimoxazole treatment.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunocompromised Hosts
  • Gastrointestinal Infections

Background:

  • Isosporiasis is an intestinal parasitic infection typically treated with trimethoprim-sulfamethoxazole.
  • Children with underlying conditions, particularly those on immunosuppressive therapy, are at increased risk for opportunistic infections.
  • Systemic vasculitis is a rare but serious autoimmune condition requiring long-term immunosuppression.

Observation:

  • A two-year-old child with a history of systemic vasculitis on prolonged corticosteroid therapy presented with severe, debilitating diarrhea.
  • The diarrhea was diagnosed as isosporiasis, a parasitic infection.
  • Standard treatment with trimethoprim-sulfamethoxazole (a dihydrofolate reductase inhibitor and sulfonamide combination) was ineffective.

Findings:

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  • The case highlights a rare association between systemic vasculitis, corticosteroid use, and severe isosporiasis.
  • The isosporiasis exhibited unusual refractoriness to trimethoprim-sulfamethoxazole, a treatment to which it typically responds well.
  • Unique clinical presentation and laboratory findings were noted, warranting further investigation.

Implications:

  • This case underscores the importance of considering unusual pathogens in immunocompromised pediatric patients.
  • It suggests that prolonged corticosteroid therapy in systemic vasculitis may predispose to treatment-resistant isosporiasis.
  • Further research is needed to understand the mechanisms behind treatment resistance and to explore alternative therapeutic strategies for such cases.