Clinical Characteristics of Seven Cases of Diarrhea Associated with a Novel Acid-Fast Organism in the Stool

In the last 4 years, we have identified an acid-fast, auto fluorescent organism in the stool of seven patients with diarrhea. The organism was identified as a cyanobacterium-like organism by the Centers for Disease Control (Atlanta) and as a coccidian by researchers in Peru and at the University of...

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Bibliographic Details
Published in:Clinical infectious diseases 1993-01, Vol.16 (1), p.136-138
Main Authors: Wurtz, Rebecca M., Kocka, Frank E., Peters, Caryn S., Weldon-Linne, C. Michael, Kuritza, Alex, Yungbluth, Peggy
Format: Article
Language:English
Subjects:
Adult
AIDS/HIV
Animal hospitals
Animals
Bacteria
Bacteria - isolation & purification
Coccidia - isolation & purification
Diarrhea
Diarrhea - microbiology
Diarrhea - parasitology
Feces - microbiology
Feces - parasitology
Humans
Male
Microbiology
Middle Aged
Nausea
Ova
Parasites
Patient assessment
Specimens
Symptoms
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Summary:In the last 4 years, we have identified an acid-fast, auto fluorescent organism in the stool of seven patients with diarrhea. The organism was identified as a cyanobacterium-like organism by the Centers for Disease Control (Atlanta) and as a coccidian by researchers in Peru and at the University of Arizona (Tucson). We present reports on the seven cases and a review of the literature. Three patients were known to be seropositive for the human immunodeficiency virus (HIV). All complained of watery diarrhea that had begun 3 days to 8 months before presentation. Colonoscopy in two patients showed a normal mucosal pattern; a biopsy for one of these patients showed chronic nonspecific inflammation of the colon. Examination of stool for ova and parasites revealed multiple oval and round nonrefractile organisms with well-defined walls that resembled large cryptosporidia; they measured 8–9 μmin diameter. These organisms did not stain by Giemsa or gram methods but were acid-fast by Kinyoun carbolfuchsin and Ziehl-Neelsen stains. The organisms fluoresced as blue under ultraviolet light. In the immunocompetent patients, diarrhea lasted an average of 19 days and resolved spontaneously. Diarrhea persisted in the HIV-seropositive patients. The clinical course and organism resembled those reported for travelers and HIV-seropositive patients. This organism may represent a newly identified cause of watery diarrhea in humans.
ISSN:1058-4838
1537-6591
DOI:10.1093/clinids/16.1.136