Nitazoxanide refractory cryptosporidiosis complicating Burkitt lymphoma in a child

Abstract

Cryptosporidium species cause watery diarrhea in several vertebrate hosts, including humans. Most apparently, immunocompetent-infected individuals remain asymptomatic, whereas immunocompromised may develop severe or chronic cryptosporidiosis. We report here the case of a 6-year-old girl undergoing chemotherapy for Burkitt lymphoma who experienced multiple episodes of watery diarrhea during her hospital stay. Microscopic examination of her stool sample revealed oocysts of Cryptosporidium species. The rapid immunochromatographic test was also positive for Cryptosporidium species. She was treated with nitazoxanide for 3 weeks, which failed to provide both clinical improvement and parasitological clearance. This case highlights the importance of treatment failure in human cryptosporidiosis.

Keywords: Burkitt lymphoma; Cryptosporidium species; nitazoxanide; refractory.

Figure 1

Oocyst of Cryptosporidium species (black arrow) in modified acid-fast stained smear of stool specimen (×400)

Figure 2

Rapid immunochromatographic test showing positive test band for Cryptosporidium species (red arrow) and control band (green arrow)