Cryptosporidium spp. in bronchoalveolar lavage samples of HIV/AIDS patients in a hospital in Guayaquil, Ecuador

Abstract

Introduction: Cryptosporidium spp. are parasites that cause respiratory infections mainly in immunocompromised patients.

Objective: To detect Cryptosporidium spp. in bronchoalveolar lavage (BAL) of HIV-positive patients with respiratory syndrome.

Methods: Sixty samples of BAL were selected and analyzed by optical microscopy with Ziehl-Neelsen staining and end-point PCR. The latter is an efficient technique for the diagnosis of opportunistic pathogens. Clinical and epidemiological data were collected from every patient. 

Results: In this study, the prevalence by end-point PCR was 5%. The most frequent signs and symptoms, mainly in the age group 31-40 years old, were fever, cough, and dyspnea. However, no significant statistical associations to any variable were obtained, and no parasites were observed with the Ziehl-Neelsen staining technique.

Conclusions: Cryptosporidium spp. can cause pulmonary infections that are difficult to identify clinically, since they are confused with other opportunistic diseases. The current study could not establish whether the detection of parasitic DNA corresponded to a real infection or only to colonization, which is important to implement diagnostic techniques with greater sensitivity. The prevalence found in Ecuador should be considered relevant, as it is unusually high in comparison with nearby countries such as Brazil.