Causative agent of isosporosis
The causative agent of human isosporiosis is Isospora belli. After peroral ingestion of sporulated oocysts and release of sporozoites, further development (schizogony, gamogony) takes place in the epithelium of the upper small intestine, leading finally to oocyst formation. In AIDS patients, encysted sporozoites have been found in various extraintestinal organs (lymph nodes, liver, gallbladder, spleen).
I. belli can cause severe clinical symptoms, especially in AIDS patients, for example persistent diarrhea, steatorrhea, cholecystitis, weight loss, and fever. Diagnosis is made by detection of unsporulated oocysts (20-30 im long) in stool (Fig. 9.111, p. 504) or of developmental stages in intestinal biopsies. High-dosed cotrimoxazole is the recommended therapy.
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