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[3 emerging protozoal infections in The Netherlands: Cyclospora, Dientamoeba, and Microspora infections]
1Afd. Medische Microbiologie, Academish Medish Centrum, Amsterdam.
Abstract:
Increased international travelling, an increased number of patients with immunosuppression caused by HIV infection, and renewed interest in known but little studied microorganisms, resulted in a more frequent finding of certain medically important parasites. Three emerging protozoal infection, Cyclospora cayetanensis, Dientamoeba fragilis and Microspora (Enterocytozoon bieneusi and Encephalitizoon) are causative agents of diarrhoea. Encephalitozoon infections are also associated with hepatitis, hepatoconjunctivitis and nephritis. C. cayetanensis infection was diagnosed in 28 patients in the years 1992-1995 in the Academic Medical Centre in Amsterdam, half of these patients returning from a visit to Indonesia. D. fragilis has a prevalence in the Netherlands of 8% among patients with diarrhoea lasting longer than one week referred for parasitological investigation. The prevalence of E. bieneusi in HIV positive patients with diarrhoea was 8-10% in the Academic Medical Centre in the last five years. Infection with Encephalitozoon appears to be endemic in the Netherlands.
Insights
Emerging protozoal infections like Cyclospora cayetanensis, Dientamoeba fragilis, and Microsporidia are increasingly diagnosed, particularly in immunocompromised individuals and international travelers. These parasites cause diarrhea and other serious health issues.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Public Health
Background:
- Global travel and increased immunosuppression (e.g., HIV) contribute to the rise of parasitic infections.
- Renewed interest in understudied microorganisms highlights emerging protozoal threats.
Purpose of the Study:
- To report on the increased detection of specific protozoal pathogens.
- To outline the prevalence and clinical significance of Cyclospora cayetanensis, Dientamoeba fragilis, and Microsporidia.
Main Methods:
- Retrospective case review and epidemiological data analysis.
- Parasitological investigations in a clinical setting.
Main Results:
- Cyclospora cayetanensis diagnosed in 28 patients (1992-1995), with half linked to travel to Indonesia.
- Dientamoeba fragilis prevalence of 8% in Dutch patients with persistent diarrhea.
- Enterocytozoon bieneusi prevalence of 8-10% in HIV-positive patients with diarrhea in Amsterdam over five years.
- Encephalitozoon infections appear endemic in the Netherlands.
Conclusions:
- Cyclospora cayetanensis, Dientamoeba fragilis, and Microsporidia are significant emerging causes of diarrhea.
- Encephalitozoon infections can lead to hepatitis, hepatoconjunctivitis, and nephritis.
- These protozoal infections require increased clinical and diagnostic attention, especially in at-risk populations.