Cryptosporidium infection in pediatric patients with lymphohematopoietic malignancies

Objective: Cryptosporidium parvum is a common protozoan, pathogen with worldwide distribution. It localizes on the intestinal cells and prolonged diarrhea in immunocompromised patients. The aim of this study was to estimate the prevalence and the clinical features of enteric cryptosporidiosis in pediatric patients with lymphohematopoietic malignancies. Material & Methods: In this cross-sectional study stool samples were collected from 100 children (67 boys, 33girls) with lymphohematopoietic malignancies who underwent chemotherapy between the ages of 6 months and 17 years (mean age 7.5 years). All of the specimens were examined for the oocysts of C. parvum by modified Ziehl Neelsen (MZN) staining technique and coproantigens of C parvum by ELISA. Findings: Cryptosporidium infection was detected in 22 patients. 16 (72.7%) of the infected patients were male and 6 (27.3) female. 7 (31.8%) patients were <5 years, 8 (36.4%) 5-10 years and 7(31.8) >10 years old. Parasites were detected in 19/85 (86.4%) patients with ALL, 2 of 5 (9.1%) with AML, and 1 of 10 (4.5%) with NHL. Clinical symptoms were found in 11 (50%) of the patients. We found longer duration of chemotherapy in patients who were positive for Cryptosporidium infection (Mean=2067 days) in comparison to negative group (Mean=258.5 days) (ANOVA, f=2.82, P=0.04). Conclusion: The incidence of cryptosporidium infection was 22% among,, pediatric patients with lymphohematopoietic malignancies. We recommend evaluation of these patients with at least two different diagnostic methods in order to prevent possible life threatening outcomes.