Parasites and Biliary stones

Cryptosporidiosis ٥٦
levels. If there is a clinical or a laboratory suspicion that there is hepatic
or biliary disease, then an ultrasound or CT scan may show a thickened
gallbladder wall, dilated or irregular intrahepatic or extrahepatic bile
ducts, or a stenotic common bile duct. Chest radiographs are also
unremarkable when there is a respiratory involvement. There may be
infiltrates or increased bronchial markings (Kourtis, 2001).
Treatment:
There is still no specific therapeutic or preventive modality approved
for cryptosporidiosis. Non-specific supportive treatment, including
rehydration and nutritional supplementation, remains the main of
management of the clinical manifestations of cryptosporidiosis. In AIDS
patients, reduction in viral load and concomitant rise in CD4 counts
achieved by anti retroviral therapy results in rapid clinical improvement
in symptoms as well as a reduction in oocyst excretion (Foudraine et
al.,1998).
The aminoglycoside paromomycin continues to be one of the few
antimicrobial agents that remains consistently in clinical use (Hewitt et
al., 2000). Nitazoxanide is a broad-spectrum, antiparasitic agent with
activity against helminths and protozoan parasites, including
Cryptosporidium (Rossignol et al., 2001). This drug is an inhibitor of
pyruvate ferredoxin oxidoreductase. Nitazoxanide is well-tolerated and
reduces the duration of diarrhea and the intensity of Cryptosporidium
oocyst shedding, after a 3-days treatment regimen (Amadi et al., 2002
and Diaz et al., 2003).