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A 53-year-old man was hospitalized for the development of watery diarrhea associated with decreased appetite and progressive weight loss and was found to have leukocytosis. The white blood cell count was 14,600/microliters with 66 percent abnormal lymphocytes. Serum anti-HTLV-I was positive and monoclonal insertion of HTLV-I provirus into the atypical cell genome was confirmed with the southern blotting hybridization technique. A diagnosis of ATL was made. Examination of fresh stool specimens revealed Isospora belli (I. belli) oocysts. Initial treatment for I. belli consisted of oral trimethoprim 160mg and sulfamethoxazole 400mg given twice daily for nine days. Diarrhea ceased within 2 days of the start of treatment, but I. belli oocysts were again detected after 20 days. Trimethoprim 160mg and sulfamethoxazole 400mg were reinstituted four times daily for 10 days, and then twice daily for 21 days. The clinical response was again dramatic, with rapid clearance of oocysts from the stool. There has been no recurrence of diarrhea. The patient's leukemia was refractory to chemotherapy; the white blood cell count continued to rise, pneumonia developed, and the patient died. I. belli is a previously unrecognized opportunistic pathogen that must be considered in the clinical setting of chronic diarrhea in patients with ATL.
T Yamane, and
K Takekawa, and
K Tanaka, and
T Hasuike, and
M Hirai, and
K Misu, and
K Ota, and
H Ohira, and
Y Nakao, and
Y Yasui
May 1992,
[Rinsho ketsueki] The Japanese journal of clinical hematology,
T Yamane, and
K Takekawa, and
K Tanaka, and
T Hasuike, and
M Hirai, and
K Misu, and
K Ota, and
H Ohira, and
Y Nakao, and
Y Yasui
September 1988,
The American journal of medicine,
T Yamane, and
K Takekawa, and
K Tanaka, and
T Hasuike, and
M Hirai, and
K Misu, and
K Ota, and
H Ohira, and
Y Nakao, and
Y Yasui
January 2006,
Turkiye parazitolojii dergisi,
T Yamane, and
K Takekawa, and
K Tanaka, and
T Hasuike, and
M Hirai, and
K Misu, and
K Ota, and
H Ohira, and
Y Nakao, and
Y Yasui
May 1993,
Medizinische Klinik (Munich, Germany : 1983),
T Yamane, and
K Takekawa, and
K Tanaka, and
T Hasuike, and
M Hirai, and
K Misu, and
K Ota, and
H Ohira, and
Y Nakao, and
Y Yasui
October 2003,
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases,
T Yamane, and
K Takekawa, and
K Tanaka, and
T Hasuike, and
M Hirai, and
K Misu, and
K Ota, and
H Ohira, and
Y Nakao, and
Y Yasui
June 1995,
Puerto Rico health sciences journal,
T Yamane, and
K Takekawa, and
K Tanaka, and
T Hasuike, and
M Hirai, and
K Misu, and
K Ota, and
H Ohira, and
Y Nakao, and
Y Yasui
July 1997,
The Journal of infection,
T Yamane, and
K Takekawa, and
K Tanaka, and
T Hasuike, and
M Hirai, and
K Misu, and
K Ota, and
H Ohira, and
Y Nakao, and
Y Yasui
April 2013,
The Korean journal of parasitology,
T Yamane, and
K Takekawa, and
K Tanaka, and
T Hasuike, and
M Hirai, and
K Misu, and
K Ota, and
H Ohira, and
Y Nakao, and
Y Yasui
May 1976,
Die Medizinische Welt,
T Yamane, and
K Takekawa, and
K Tanaka, and
T Hasuike, and
M Hirai, and
K Misu, and
K Ota, and
H Ohira, and
Y Nakao, and
Y Yasui
August 1989,
Revista medica de Chile,
