Izosporoz

Description:

Izosporoz of the person is called by Sporozoa of Isospora belli (Isospora hominis). Parasites breed in cells of an epithelium of a mucous membrane of a small bowel, passing there cycles of a schizogony, a syngenesis and a sporogony which comes to an end in external environment.

Reasons of an izosporoz:

Isodisputes are eurysynusic in the nature, them there are more than 200 types, but only 2 of them cause pathology in the person. Izosporoz - антропоноз as with I. belli and I. natalensis strike only the person.

Pathogeny:

Source of an infection is the person. Infection occurs at the use of the water contaminated by oocysts or foodstuff. Diseases are more often observed at children, both sporadic, and small epidemic flashes (in child care facilities). In the tropical countries incidence is much higher.

Isodisputes take place a sexless development cycle in external environment, creating oocysts.
The person catches an alimentary way: oocysts get into his intestines with contaminated by water and food. The development cycle an isodispute in intestines can be sexless (in these cases parasites, being implemented into epithelial cells of a mucous membrane of duodenal and lean guts, pass repeatedly repeating fissiparity cycle therefore all new and new cells are involved in process). From separate merozoites (one of stages of development of a parasite) sex cells which, merging, form unripe oocysts form. Oocysts are colourless, transparent, have the oval form (preferential), a thin double-circuit cover, the sizes of 25-30 x 12-15 microns. Further maturing of the oocysts which got to external environment at defecation happens in the soil.

Reproduction leads an isodispute in epithelial cells of intestines to its damage, disturbance of processes of absorption of liquid and nutrients from an intestines gleam - the diarrheal syndrome which is followed by a colicy pain in a stomach develops. The chair is frequent, watery, temperature is more often subfebrile.

Process in an immunocompetent organism usually proceeds favorably, all phenomena abate not later than in 7-10 days even without treatment. At much infected a diarrheal syndrome does not develop in general though isodisputes are found in excrements.

Symptoms of an izosporoz:

The clinic of an izosporoz is characterized by enteritis symptoms. The incubation interval proceeds 5-7 (to 10) days. The disease begins with fervescence (sometimes to 39 °C). The feverish period can proceed about one week. Along with fervescence or for the 2-3rd day profuse watery diarrhea, sometimes with impurity of a small amount of slime and blood develops after that. At a part of patients vomiting is observed. In certain cases oocysts can be found in excrements of the people who do not have explicit clinical manifestations. Usually the disease proceeds sharply, coming to an end with recovery in 7-20 days after its beginning. Severe choleroid forms of an izosporoz and cases of its long current are occasionally observed. They are noted at persons with reduced immunity or at patients with AIDS. In these cases parasites can go beyond a mucous membrane of a small bowel and cause development of the disseminated izosporoz who quite often leads to death of the patient.

Diagnosis:

The diagnosis of an izosporoz is established at detection of oocysts of koktsidiya in native smears a calla, and also in the smears painted by solution of Lugol or 1% solution of bichromate potassium. Viewing of drugs is made at increase 10x40 or 7x40. As oocysts almost transparent, them it is easier to notice at the lowered condenser and a half-closed diaphragm. As parasites in Calais are always not enough and they are found hardly, it is necessary to investigate a series of fecal samples, looking through in everyone till 8-10 drugs and not less than 100 fields of vision in each of them. For increase in efficiency of diagnosis it is also recommended to carry out flotation of the studied material in saturated solution of table salt by Fyulleborn's method.

Also the method of Darlington which consists that excrements mix up with water is applied and are centrifuged before receiving a dense deposit. Then the deposit is stirred in mix of equal parts of table salt with glycerin and again is centrifuged. After that from a surface a loop take away a film for a research.

Microscopic drugs.  In the smears painted by solution of Lugol and iron hematoxylin, oocysts have an appearance of oblong and ellipsoidal little bodies which one or two ends are sometimes narrowed. Their sizes - 20 - 33 x 1O - 19 (30х12) microns. Wall of oocysts thin, smooth and colourless. In unripe oocysts the cytoplasm concentrated in the center forms a granular sphere with a kernel in the form of a light roundish spot. In mature cysts the oval sporocysts covered with own cover with four extended, zapyatovidny sporozoita and residual bodies in everyone are visible two.

Cultural and immunological methods in diagnosis of an izosporoz are not applied.

Treatment of an izosporoz:

Apply metronidazole to sanitation of patients, фансидар, фазижин and other drugs. It is necessary to remember toxicity of many remedies and their not really high performance.