Cryptosporidium

parvum
 HISTORY AND DISTRIBUTION

• First observed in the gastric mucosal

crypts of laboratory mice Tyzzer in 1907.
• First human case reported in 1976.

• Causes diarrhea in humans and animals

• Frequent cause of intractable diarrhea in
AIDS patients and immunocompromised
subjects
• Worldwide distribution
• C.parvum and C.hominis causes human
infections
 HABITAT

• Parasite-intra cellular
• Jejunum, ileum and
colon
 MORPHOLOGY

• Infective form- oocyst

• Spherical, oval, 5µm in
diameter
• Does not stain with iodine
and is acid fast
• 80%Thick walled-
excreted in feces
• but 20%thin walled-
autoinfection
• 4 elongated
sporozoites (in
both thick and
thin walled)
• Very hard and resistant.
Temperature-60ºC
• Sequential application of
ozone and chlorine –
 LIFE CYCLE

• Monoxenous
• Suitable host- man
• Reservoirs-man, cattle, cat, dog
• Mode of transmission:
– Faeco –oral route
– Ingestion of contaminated food and water
– Autoinfection
• Infective form-Oocyst
 PATHOGENICITY

• Humans get infection by:

– Ingestion of contaminated food and water
with feces
– Direct contact with infected animals
– Human to human transmission
• Incubation period 2-14 days
 CLINICAL FEATURES

• Immunocompetent person
– Asymptomatic or self limiting febrile illness
– Watery diarrhea, abdominal pain, nausea, weight loss
– Childhood and travelers diarrhea
– Extra int infection- R.tract

• Immunocompromised person
– AIDS and CD4+Tcell counts<100/µL
– Chronic, persistent profuse diarrhea. Significant fluid
and electrolyte depletion
– Weight loss, emaciation, abdominal pain
– Stool volume:1-25 L/day
– Billiary tract involvement-right upper quadrant pain,
sclerosing cholangitis or cholecystitis
 LABORATORY
DIAGNOSIS

Stool Histopathological Serodiagnosis Molecular

examination examination
diagnosis
 STOOL EXAMINATION

• Diagnosis is made by demonstration of oocystes

in feces
• Direct wet mount- colorless spherical oocyst,4-
5µm containing large and small granules
• Modified acid fast stain-oocyst appears as red
acid fast spheres
• Sheathes sugar floatation test and zinc sulfate
floatation technique
• Florescent staining with aluminum phenol or
acridine orange
• Indirect immunoflurescence microscopy using
specific antibody
C.PARVUM IN FLUORESCENT
MICROSCOPY
 HISTOPATHOLOGICAL EXAMINATION

• Light and electron microscopy

• Intestinal epithelium of biopsy specimen
• Jejunum is preferred
 CRYPTOSPORIDIUM

In liver
oocysts
Flotation Methods

SHEATHER’S SUGAR CENTRIFUGAL

FLOTATION TECHNIQUE
Raed Z. Ahmed, Medical Parasitology Lab.,2012
MATERIALS AND METHOD

Sheather’s sugar solution:

Table sugar -------------------------------------- 500gm
Distilled water ---------------------------------- 320ml
Phenol crystal ( melt in hot water bath) ----- 6.5gm
 PROCEDURE
1. Soften 1gm of feces with water .
2. Strain the aqueous suspension through a wire sieve.
3. Mix 1 part aqueous suspension with 2 part of
Sheather's sugar solution.
4. Pour into a centrifuge tube, centrifugation 1500
rpm for 10 minutes.
5. Pour the supernatant into a meniscus and add a
sufficient solution to bring the meniscus to the top.
6. Place a coverslip and wait for 10 minutes.
7. Examine under microscope.
SHEATHER’S SUGAR SOLUTION TECHNIQUE

Advantages:
Reveals most nematode eggs and protozoan cyst.

Disadvantages:
Flukes eggs and tape worm eggs are not demonstrate well.
Also most nematode larvae are not demonstrate well.
 SERODIAGNOSIS

• Antibody specific to C.parvum can be

demonstrated within 2 months of acute
infection
• ELISA
 MOLECULAR DIAGNOSIS

• Western blot technique- 17KDA and

27KDA sporozoite antigen
 TREATMENT

• Disease is self limiting

• Nitazoxanide or parmomycin – partially
effective
• Antiretroviral therapy can lead to
amelioration of
cryptosporidiosis.
• Supportive therapy wit fluid,
electrolytes and nutrient replacement
THANK YOU