The use of oral immunoglobulin in the treatment of cryptosporidium in immunocompromised children

Abstract EN

A seven month old baby presented with pelvic rhabdomyosarcoma and treated with Ifsophamide, vincristine and actinomycin D.

A week after chemotherapy he developed diarrhoea, vomiting and febrile neutropenia and was given broad spectrum antibiotics and metronidazole.

The fever settled but the diarrhoea and vomiting persisted.

Stool cultures grew cryptosporidium which did not respond to the conventional treatment.

Oral immunoglobulin was given for 4 days, following which the diarrhoea and vomiting became less frequent and the condition improved.

Repeated stool cultures failed to grew cryptosporidium.

We conclude that crypto-sporidium can cause diarrhoea in the immunocompromised children and that oral immunoglobulins appear to be an effective mode of therapy.

Bahrain Med Bull 1996;18(1): Protozoa of the genus cryptosporidium are uncommonly recognised pathogen of the human intestinal tract.

They exist in nature as zoonoses involving such animals as cows and sheeps, with transmission via the faecal-oral route of the oocyst that are infective at the time of passages1 .

In immunologically normal children, the protozoan generally causes an acute, self limiting illness of 5-10 days duration and characterised by watery diarrhoea, abdominal pain and nausea2.

By contrast, cryptosporidial infection in immuno-compromised children may produce severe life threatening diarrhoea that persists for months or years3 .

Recently it was advocated that oral immunoglobulin can be used to treat immunocompromised children with cryptosporidial infection4,5.

We report a child who presented with cryptosporidial infection shortly after starting him on chemotherapy.

This child had prompt resolution of his symptoms soon after starting him on oral immunoglobulin.

THE CASE Seven months old baby was diagnosed as pelvic