Coccidian/cyanobacterium-like bodies as a cause of diarrhea in Australia

Abstract

Coccidian/cyanobacterium-like bodies (CLBs) were detected in the stool specimens of 5 Australian patients over a 6 mth period from July to December, 1992. Four of the 5 patients had recent travel history to a neighbouring overseas destination, including Papua New Guinea and Bali, Indonesia. These 4 patients had clinical presentations of acute onset, recurrent diarrhea which was prolonged and accompanied by weight loss, anorexia and lethargy. These symptoms are consistent with reports from other countries as being associated with CLBs. Large numbers of CLBs were detected by microscopic examination of direct and stained preparations of the stool specimens from these patients during the course of illness. In contrast, the one patient without any foreign travel history exhibited only mild diarrhea of short duration with only small numbers of CLBs detected in the stool specimen. Fecal examinations for bacterial and viral enteric pathogens were negative. Fecal reducing substances were not detected in the one child patient. Examinations for other parasitic enteric pathogens were all negative except for the detection of low numbers of Blastocystis hominis in one patient. CLBs should be considered as a possible etiology of unexplained diarrhea in patients who have returned to Australia from neighbouring tropical countries. Variation from the well documented clinical syndrome which has been attributed to infection with this organism may occur. CLBs may be endemic to Australia and neighbouring countries. If so, many more cases of CLB associated illness will be encountered.