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Isospora belli enteritis in three homosexual men
Abstract:
Isospora belli is an uncommon cause of diarrhea in man. Like the closely related Cryptosporidium, the organism causes disease that may be more severe and chronic in patients with underlying immune deficiency states. We describe three male homosexuals with Isospora enteritis. Each had several months of diarrhea. All three patients had lymphopenia and two had profound T cell helper-suppressor ratio reversal. In addition, two of the patients admitted to oral-anal contact, a practice associated with the acquisition of parasites and other enteric pathogens in the homosexual population. We suggest that Isospora belli may be a sexually transmitted pathogen which should be considered in the diagnosis of homosexual patients with diarrhea.
Insights
Isospora belli is an uncommon cause of diarrhea. This parasite may cause severe illness in immunocompromised individuals, and sexual transmission is suspected in homosexual men.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Immunology
Background:
- Isospora belli is an infrequent cause of human diarrhea.
- It can lead to severe, chronic illness in immunocompromised individuals, similar to Cryptosporidium.
Observation:
- Three homosexual men presented with prolonged diarrhea.
- All patients exhibited lymphopenia, with two showing significant T cell helper-suppressor ratio reversal.
Findings:
- Isospora enteritis was diagnosed in all three patients.
- Two patients reported oral-anal contact, a known risk factor for enteric infections in this population.
Implications:
- Isospora belli may be a sexually transmitted pathogen.
- Consider Isospora belli in the differential diagnosis of diarrhea in homosexual men, especially those with immune deficiencies.