CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES >
HIV co-infection with Blastocystis hominis and Giardia lamblia in a patient
Received date: 2021-09-30
Revised date: 2021-11-05
Online published: 2022-07-06
Supported by
Fundamental Research Funds for central Universities of Wuhan University(2042020kfxg05)
A 64-year-old female patient, who is a farmer, was admitted to the hospital for intermittent pain and discomfort in the lower back. The patient was positive for human immunodeficiency virus (HIV) antigen/antibody test. Blastocystis hominis and Giardia lamblia flagellate cysts were found by microscopic examination for the normal saline smear of the fecal sample. The B. hominis cysts were round, oval, and varying in size, with 1 to 2 granular nuclei. Vacuoles were seen in the middle of the iodine-stained parasites with irregular, shiny, crescent-like edges between the vacuoles and the cell membrane. Many small bright spots were seen in the vacuoles. The G. lamblia flagellate cysts are oval in shape, with thick cyst walls. There is a clear gap between the cyst and the parasite. The iodine stains the inner axis of the cyst with 2 to 4 nuclei. The nuclei are located on both sides of the axis. Four purplish red nuclei were evident in the cyst after hematoxylin staining. Nested PCR amplified a 511 bp band from patient fecal DNA, which was 99% identical to the sequence TSA417 of G. lamblia (GenBank accession number AF065606). The ribosomal small subunit gene was amplified by PCR with the specific primers of BhRDr and RD5 of B. hominis, and a band of approximately 600 bp was amplified. The sequencing suggested it was B. hominis ST1 type. Combined with the patient’s epidemiological history of drinking unboiled water, using dry-toilet, breading cats and dogs, etc., the diagnosis of HIV co-infection with B. hominis and G. lamblia was made. After 4 days of treatment with metronidazole (0.2 g/time, 3 times/d), the patient’s symptoms were relieved, and the patient was discharged.
ZHU Ming-chao , ZHU Ya . HIV co-infection with Blastocystis hominis and Giardia lamblia in a patient[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2022 , 40(3) : 315 -318 . DOI: 10.12140/j.issn.1000-7423.2022.03.024
| [1] | Qiao JY,, Xue HX, Turxunai. Morphological observation on Blastocystis hominis[J]. Chin J Parasitol Parasit Dis, 1998, 16(2): 46-47. (in Chinese) |
| [1] | ( 乔继英,, 薛弘燮,, 吐尔逊艾. 人芽囊原虫形态学的观察[J]. 中国寄生虫学与寄生虫病杂志, 1998, 16(2): 46-47.) |
| [2] | Zhang X,, Qiao JY,, Li Y, et al. Morphological observation of Blastocystis hominis and its relationship with diarrhea[J]. J Xi’an Med Univ Chin, 2001, 22(6): 588. (in Chinese) |
| [2] | ( 张旭,, 乔继英,, 李影, 等. 人芽囊原虫的形态观察及与腹泻的关系[J]. 西安医科大学学报, 2001, 22(6): 588.) |
| [3] | He JG,, Jing JB,, Zhou H, et al. Studies of light microscope appearance and ultrastructure of Blastocystis hominis in vitro culture[J]. Acta Scifntiarum Nat Univ Sunyaatseni, 1990, 29(3): 122-128. (in Chinese) |
| [3] | 何建国,, 江静波,, 周宏, 等. 人芽囊原虫的光学和超微结构研究[J]. 中山大学学报(自然科学版), 1990, 29(3): 122-128.) |
| [4] | Song P,, Zhang YN,, Li H, et al. A case of Giardia lamblia infection[J]. Chin J Parasitol Parasit Dis, 2016, 34(6): 580. (in Chinese) |
| [4] | ( 宋鹏,, 张永年,, 李浩, 等. 蓝氏贾第鞭毛虫感染1例[J]. 中国寄生虫学与寄生虫病杂志, 2016, 34(6): 580.) |
| [5] | He SZ,, Liu RB. A case of chronic gastritis with Giardia lamblia infection[J]. Inter J Epidemiol Infect Dis, 2017(2): 143-144. (in Chinese) |
| [5] | ( 何松哲,, 刘瑞彪. 慢性胃炎伴蓝氏贾第鞭毛虫感染一例[J]. 国际流行病学传染病学杂志, 2017(2): 143-144.) |
| [6] | Rito ZL,, Luis H,, Naquira C, et al. A simplified culture method for Blastocystis hominis[J]. Rev Mex Patol Clin, 2000, 47: 17-19. |
| [7] | Stenzel DJ,, Lee MG,, Boreham PFL. Morphological differences in Blastocystis cysts: an indication of different species?[J]. Parasitol Res, 1997, 83(5): 452-457. |
| [8] | Windsor JJ,, MacFarlane L,, Hughes-Thapa G, et al. Incidence of Blastocystis hominis in faecal samples submitted for routine microbiological analysis[J]. Br J Biomed Sci, 2002, 59(3): 154-157. |
| [9] | Duda A,, Kosik-Bogacka D,, Lanocha N, et al. Blastocystis hominis: parasites or commensals?[J]. Ann Acad Med Stetin, 2014, 60(1): 23-28. |
| [10] | Phillips BP,, Zierdt CH. Blastocystis hominis: pathogenic potential in human patients and in gnotobiotes[J]. Exp Parasitol, 1976, 39(3): 358-364. |
| [11] | Hu Y,, Li YW,, Lu ZC. Clinical analysis of Blastocystis hominis infection in 1 185 patients with chronic diarrhea in 2011[J]. Chin Trop Med, 2012, 12(6): 713-715, 718. (in Chinese) |
| [11] | ( 胡缨,, 李艳文,, 卢作超. 慢性腹泻患者1 185例感染人芽囊原虫的临床分析[J]. 中国热带医学, 2012, 12(6): 713-715, 718.) |
| [12] | Lu ZC,, Hu Y,, Liu XQ, et al. Analysis intestinal parasitic infection status of 12 313 cases of hospital patients in Nanning city, Guangxi[J]. J Trop Med, 2015, 15(5): 677-680. (in Chinese) |
| [12] | ( 卢作超,, 胡缨,, 刘晓泉, 等. 南宁12 313例医院就诊者肠道寄生虫感染状况分析[J]. 热带医学杂志, 2015, 15(5): 677-680.) |
| [13] | Yason JA,, Liang YR,, Png CW, et al. Interactions between a pathogenic Blastocystis subtype and gut microbiota: in vitro and in vivo studies[J]. Microbiome, 2019, 7(1): 30. |
| [14] | Wu S,, Li GQ. Research progress on the pathogenic mechanism of Giardia lamblia[J]. Chin J Animal Infect Dis, 2015, 23(1): 64-70. (in Chinese) |
| [14] | ( 武省,, 李国清. 蓝氏贾第虫致病机制的研究进展[J]. 中国动物传染病学报, 2015, 23(1): 64-70.) |
| [15] | Escobedo AA,, Almirall P,, Alfonso M, et al. Sexual transmission of giardiasis: a neglected route of spread?[J]. Acta Trop, 2014, 132: 106-111. |
| [16] | Gonçalves ACM,, Gabbay YB,, Mascarenhas JD, et al. Calicivirus and Giardia lamblia are associated with diarrhea in human immunodeficiency virus-seropositive patients from southeast Brazil[J]. Am J Trop Med Hyg, 2009, 81(3): 463-466. |
| [17] | Saghaug CS,, Sørnes S,, Peirasmaki D, et al. Human memory CD4+ T cell immune responses against Giardia lamblia[J]. Clin Vaccine Immunol, 2016, 23(1): 11-18. |
| [18] | Zhu YJ,, Xu ZP,, Ji MJ. Advances in the research on the interaction between human parasites and gut microbiota[J]. Chin J Schisto Control, 2020, 32(6): 649-653. (in Chinese) |
| [18] | ( 朱元杰,, 徐志鹏,, 季旻珺. 人体寄生虫与肠道菌群相互作用的研究进展[J]. 中国血吸虫病防治杂志, 2020, 32(6): 649-653.) |
| [19] | Karp CL,, Auwaerter PG. Coinfection with HIV and tropical infectious diseases. Ⅱ. Helminthic, fungal, bacterial, and viral pathogens[J]. Clin Infect Dis, 2007, 45(9): 1214-1220. |
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