Abstract Cystoisospora belli infection manifests as diarrhea, and can potentially progress to malabsorption in HIV patients. Here, we report a case of C. belli infection in an HIV/AIDS patient with chronic diarrhea symptoms for at least 2 years. Coproscopic analyses based on direct technique and modified Ziehl-Neelsen technique without a commercial kit were performed. The current case report highlights the protocol to be adopted in coproscopic analyses applied to HIV patients. The importance of including the appropriate parasitological testing of patients with chronic intestinal isosporiasis in parasitological test routines must be considered.

Resumo Introdução Manipuladores de alimentos que trabalham em hospitais frequentemente fornecem alimentos a indivíduos com imunidade reduzida, os quais são mais suscetíveis à aquisição de doenças infecciosas de origem alimentar. Objetivo O objetivo deste trabalho foi avaliar a presença de enteroparasitos e coliformes termotolerantes nas mãos dos manipuladores de alimentos de um hospital de ensino de Uberaba, Minas Gerais. Método Foram analisadas amostras das mãos de 44 manipuladores de alimentos de um hospital de ensino. Os coliformes termotolerantes foram contados pelo método do Número Mais Provável, a partir de amostra obtida por esfregaço. O conteúdo subungueal foi submetido à análise parasitológica, observado em microscópio. Resultados 15,9% (7/44) das amostras foram positivas para ocorrência de coliformes termotolerantes e 9,1% (4/44) dos conteúdos subungueais foram positivos para protozoários intestinais (3 Blastocystis spp. e 1 Giardia spp.). Conclusão Os resultados indicam contaminação das mãos dos manipuladores de alimentos e predisposição à veiculação de agentes patogênicos por essa via, ressaltando a importância de uma conscientização dos manipuladores de alimento quanto à higiene pessoal e dos alimentos, bem como a utilização de medidas preventivas.

Abstract Background Inappropriate food handling is the main cause of foodborne illnesses. Food handlers perform important functions to preserve the hygiene food that can be a source of transmission of various pathogens. Objective The aim of this study was to evaluate the presence of intestinal parasites and microorganisms indicators of fecal contamination (thermotolerant coliforms) in the hands of food handlers of a teaching hospital in Uberaba, Minas Gerais state, Brazil. Method Samples from the hands of 44 food handlers of a teaching hospital were analyzed. Thermotolerant coliforms were counted by the Most Probable Number method using samples obtained by smearing. The subungual content was subjected to parasitological analysis under microscopy. Results 15.9% (7/44) of the samples were positive for the presence of thermotolerant coliforms and 9.1% (4/44) of the subungual contents were positive for intestinal protozoa (3 Blastocystis spp. and 1 Giardia spp.). Conclusion Results indicate contamination of the food handlers’ hands and predisposition to transmission of pathogens by this route, emphasizing the importance to make food handlers aware of personal and food hygiene, as well as to apply preventive actions.

Introduction Cryptosporidium is an important protozoan cause of waterborne disease worldwide of concern to public health authorities. To prevent outbreaks of cryptosporidiosis, the monitoring of this parasite in drinking water is necessary. In the present work, the polymerase chain reaction (PCR) and nested-PCR techniques were used to detect Cryptosporidium in raw water from catchment points of four water treatment plants (WTP) in Curitiba, Paraná, Brazil. Methods First, DNA extraction techniques were tested in samples containing decreasing amount of oocysts in reagent water, and PCR and nested-PCR with specific primers for 18SSU rDNA of Cryptosporidium were conducted to determine their sensitivity. In reagent water, a commercial extraction kit provided the best analytical sensitivity, and PCR and nested-PCR allowed the detection of five and two oocysts, respectively, with the primers XIAOR/XIAOF and XIAO1F/XIAO2R. Results In the spiking experiments, only the PCR with the primers AWA995F/AWA1206R was successful at detecting concentrations of 0.1 oocysts/mL. Two catchments samples of raw water and/or water sludge from four WTPs were contaminated with Cryptosporidium. Conclusions The application of the techniques to monitor Cryptosporidium in water and detect contamination in water catchments of WTPs in Curitiba are discussed in the present work.

INTRODUÇÃO: A produção de anticorpos policlonais anti-Cryptosporidium e sua utilização na imunofluorescência para determinar a presença de Cryptosporidium em água são descritas no presente trabalho. MÉTODOS: Dois coelhos foram imunizados com antígeno solúvel e particulado provenientes de oocistos purificados de Cryptosporidium. O soro produzido foi preparado para a extração de imunoglobulinas G, que foram purificadas e conjugadas com isotiocianato de fluoresceína (FITC). Lâminas contendo quantidades conhecidas de oocistos foram preparadas para determinar a sensibilidade da técnica. Para testar a especificidade foram preparadas lâminas contendo cistos de Giardia duodenalis. RESULTADOS: O conjugado foi usado com sucesso em amostras de água contaminadas experimentalmente com oocistos de Cryptosporidium, sendo capaz de detectar até cinco oocistos/spots que corresponde a uma contaminação de 250 oocistos/mL. CONCLUSÕES: As três imunizações realizadas nos coelhos foram suficientes para produção de anticorpos contra Cryptosporidium; a reação de imunofluorescência direta padronizada permitiu a detecção de cinco oocistos em 20% das amostras; não houve reação cruzada com cistos de Giardia duodenalis.

INTRODUCTION: The production of anti-Cryptosporidium polyclonal antibodies and its use in direct immunofluorescence assays to determine the presence of Cryptosporidium in water are described in the present work. METHODS: Two rabbits were immunized with soluble and particulate antigens from purified Cryptosporidium oocysts. The sera produced were prepared for immunoglobulin G extraction, which were then purified and conjugated with fluorescein isothiocyanate (FITC). Slides containing known amounts of oocysts were prepared to determine the sensitivity of the technique. To test the specificity, slides containing Giardia duodenalis cysts were prepared. RESULTS: The conjugate was successfully used in water samples experimentally contaminated with Cryptosporidium oocysts, and it was possible to detect up to five oocysts/spot, corresponding to contamination of 250 oocysts/mL. CONCLUSIONS: The three immunizations performed in the rabbits were enough to produce antibodies against Cryptosporidium, the standard direct immunofluorescence assay permitted the detection of five oocysts in 20% of the samples, and no cross-reaction with Giardia duodenalis cysts occurred.

Paciente sadio em que, ao exame de rotina, foi detectado nódulo pulmonar esquistossomótico com verme adulto, 25 anos após o tratamento específico com oxamniquine® e distante da região endêmica. O nódulo simulava clinicamente neoplasia.

Healthy patient in which during ordinary examination a pulmonary schistosomotic nodule with an adult parasite, was detected 25 years far from endemic region and after specific treatment with oxamniquine®. Clinically the nodule simulated neoplasia.

Descreve-se a presença de cistos unizóicos de Isospora belli em linfonodos mesentéricos e de gametócitos no epitélio da vesícula biliar de um paciente brasileiro de 26 anos de idade, com a Síndrome da Imunodeficiência Adquirida que recebeu tratamento, por diversas vezes, com sulfametoxazol-trimetoprim. Discute-se a importância dos cistos teciduais de I. belli como possíveis focos de resistência do parasita e a associação destes a episódios de recidivas da infecção mesmo após tratamento com medicação anticoccídios.

This report describes the presence of Isospora belli unizoic cysts in mesenteric lymph nodes and of gametocytes in the gallbladder epitelium of a 26 year-old Brazilian male patient with Acquired Immune Deficiency Syndrome. This patient had received treatment for several times with sulfamethoxazole-trimethoprim. It is discussed the significance of I. belli tissue cysts as possible foci of resistance of the parasite and their association with the infection relapse even post-treatment with anticoccidian medication.

Os autores descrevem caso de enterobíase peritoneal apresentando-se como granuloma necrosante, em adolescente com tumor do seio endodérmico do ovário. O diagnóstico foi estabelecido por biópsia de nódulo do epíploon, durante laparotomia para reestadiamento de câncer de ovário após tratamento clínico. Nódulos granulomatosos peritoneais causados por parasitas podem simular metástases, confundindo o estadiamento de neoplasias.

The authors describe a case of peritoneal enterobiasis presenting as necrotizing granuloma, in a adolescent with tumor of the ovarian endodermic sinus. The diagnosis was established through biopsy of peritoneal nodule, during laparotomy for staging system of ovarian cancer. Granulomatous nodules due to parasites could simulate metastasis, and cause confusion in the staging system for cancer.