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Journal of Tropical Pediatrics 2003 49(2):128-130; doi:10.1093/tropej/49.2.128
© 2003 by Oxford University Press
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Case Report

Eradication of Cryptosporidium in Four Children with Acute Lymphoblastic Leukemia

Omar Trad1, Pauline Jumaa2, Sayenna Uduman3 and Akhtar Nawaz4

1 Department of Pediatrics, Tawam Hospital, Al Ain, United Arab Emirates 2 Department of Laboratories, Tawam Hospital, Al Ain, United Arab Emirates 3 Faculty of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates 4 Department of Pediatric Surgery, Al Ain Hospital, Al Ain, United Arab Emirates

Four children on chemotherapy for acute lymphoblastic leukemia presented with severe diarrhea and dehydration. Cryptosporidium was identified in the stools using modified Ziehl–Neelsen stain. Two of them received paromomycin and responded well. One was started on paromomycin for 10 days and although there was clinical improvement, his stools examination continued to be positive for Cryptosporidium. He then received azithromycin for 10 days. He responded well and his stools became negative for Cryptosporidium. The fourth patient received azithromycin from the start and responded well. Cryptosporidium should be considered in all immunocompromised children with severe or prolonged diarrhea, and since it is not seen in a routine ova and parasite examination, the laboratory should be notified for diagnostic confirmation using modified Ziehl–Neelsen stain. Immunocompromised children with Cryptosporidium diarrhea may benefit from paromomycin or azithromycin therapy.


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