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Endogenous development of Cystoisospora belli in intestinal and biliary epithelium of humans

Published online by Cambridge University Press:  12 March 2019

J. P. Dubey Open the ORCID record for J. P. Dubey [Opens in a new window] ,
Kimberley J. Evason  and
Zenta Walther
J. P. Dubey*
Affiliation:
United States Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Animal Parasitic Diseases Laboratory, Beltsville, Maryland, 20705-2350, USA
Kimberley J. Evason
Affiliation:
Department of Pathology and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
Zenta Walther
Affiliation:
Department of Pathology, Yale University School of Medicine, New Haven, CT 06520-8023, USA
*
Author for correspondence: J. P. Dubey, E-mail: jitender.dubey@ars.usda.gov
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Abstract

Cystoisospora (Isospora) belli is a coccidian parasite of humans. It can cause serious digestive disorders involving infection of intestines, biliary tract and gallbladder, especially in those with depressed immunity. It has a direct fecal–oral transmission cycle. After ingestion of sporulated oocysts, the parasite multiplies asexually and sexually within host epithelial cells, resulting in unsporulated oocysts that are excreted in feces. The details of asexual and sexual stages are not known and certain inclusions in epithelial cells in biopsy samples have been erroneously identified recently as C. belli. Here, we provide details of developmental stages of C. belli in two patients, in duodenal biopsy of one and biliary epithelium of the other. Immature and mature asexual stages (schizonts/meronts) were seen in epithelial cells. The merozoites were seen singly, in pairs and in groups in single parasitophorous vacuole (pv) in host cytoplasm. Immature and mature meronts were seen together in the same pv; up to eight nuclei were seen in meronts that retained elongated crescent shape; round multinucleated schizonts, seen in other coccidians, were not found. Meronts were up to 25 µm long and contained up to ten merozoites that were 8–11 µm long. The merozoites and meronts contained PAS-positive granules. Microgamonts (male) contained up to 30 nuclei that were arranged at the periphery and had condensed chromatin; 1–3 PAS-positive, eosinophilic, residual bodies were left when microgametes were formed. The microgametes were 4 µm long and PAS-negative. All stages of macrogamonts, including oocysts were PAS-positive. The detailed description of the life cycle stages of C. belli reported here should facilitate in histopathologic diagnosis of this parasite.

Keywords

CoccidiaCystoisospora (Isospora) belligamontsmerontsmerozoitesoocystsprotozoaschizonts
Type
Research Article
Information
Parasitology , Volume 146 , Issue 7 , June 2019 , pp. 865 - 872
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Copyright
Copyright © Cambridge University Press 2019 

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