Isosporiasis

　　Isospora infection is caused by Isospora parasites, and the specific pathogenic causes are as follows:

　　1. Besi Isospora parasites in the human duodenal distal and proximal jejunum epithelial cells. The patient's feces contain oocysts, which are the infective stage of this parasite. The oocysts are elongated ovoid, with a size of approximately (20～33)μm×(10～19)μm. One end is slightly narrow, resembling a bottle neck. The cyst wall has two smooth and transparent layers. The inner layer is filmy, and the outer layer is harder and has lower permeability. Freshly excreted oocysts usually contain one sporocyst cell, but sometimes two. After the feces are excreted, the sporocyst cell divides into two and secretes the cyst wall, forming sporocyst of about (7～9)μm×(12～14)μm. Each sporocyst undergoes two divisions, ultimately forming four sporozoites and a mass of granular remnants. The sporozoites are slender like a crescent. Therefore, each mature oocyst contains two sporocysts, and each sporocyst contains four sporozoites.

　　The life cycle of Isospora includes schizogamy, gametogamy, and sporogony, with the first two occurring in the host. If a person accidentally ingests food or water contaminated with mature oocysts, the oocysts break due to the action of digestive juices in the small intestine, and the sporozoites escape and enter the intestinal mucosal epithelial cells to develop into trophozoites. After several rounds of schizogamy, the trophozoites produce a large number of schizonts. The schizonts break open to release the schizonts, which then enter adjacent epithelial cells to continue the schizogamy process. Approximately one week later, some schizonts develop into male and female gametocytes and male and female gametes within the epithelial cells or in the intestinal lumen. After mating, the zygotes form oocysts by secreting the cyst wall, which develop within the body or are excreted with feces and continue to develop.

　　The pathogenesis of this disease has not been elucidated. The parasites侵入the intestinal mucosal epithelium and repeatedly divide, which can lead to damage and erosion of the intestinal mucosa, and a decrease in absorption function. The metabolic products of the parasites may also have toxic effects. The examination of living tissue can show destruction of the small intestinal mucosal epithelial cells, atrophy of the mucosal villi, and in some patients, villi extending and the tips becoming thicker or focal villous hypoplasia. There is a significant deposition of collagen in the lamina propria, and a large number of eosinophils, monocytes, and lymphocytes infiltrate. A large number of parasites at different developmental stages can also be found in the mucosal epithelium. Chronic patients often have shortened villi and deepened crypts in the intestinal mucosa; in addition to eosinophils, neutrophils also infiltrate the lamina propria.

　　Complications of Isospora infection are relatively rare, but in some cases, they can lead to chronic diarrhea, electrolyte imbalance, persistent or fatty diarrhea, weight loss, and even death. Due to damage to the intestinal mucosa, diarrhea and vomiting can lead to electrolyte imbalance. If the condition is not treated in time, or in severe cases, it can lead to fatty diarrhea, malnutrition, and concurrent multiple organ failure, which can ultimately lead to death.

　　Isospora infection can last for several weeks to several years, with most symptoms mild, diarrhea being the main symptom. Stools are often mucoid, and eosinophils are often present in large numbers, but neutrophils are rare. Diarrhea can occur several times a day, but there are also reports of more than twenty times a day for 3-4 days, with periodic attacks lasting for several months. In addition, patients often have abdominal pain, fever, nausea, vomiting, decreased appetite, weight loss, and a few patients have malabsorption of the small intestine, especially poor fat absorption, with large fat particles in the stool. In foreign 'volunteer' experimental infections or accidental infections of laboratory staff, symptoms are common, including abdominal discomfort, low fever, and diarrhea, which begin one week after infection and can heal within 5-10 days. However, the excretion of oocysts in feces can continue for 10-20 days. There are asymptomatic carriers of the disease, but due to the frequent omission of oocysts in feces, the exact number of asymptomatic carriers cannot be determined.

　　Preventive measures for Isospora infection include the following aspects:

　　1. Do not drink cold water, do not eat raw food and unclean fruits and vegetables.

　　2. Wash hands before and after meals and often trim nails.

　　3. Cook food thoroughly, especially when grilling or eating hotpot.

　　4. Educate children to change their habit of eating their fingers and biting their nails.

　　5. It is best to let children wear underwear with no crotch to sleep to prevent them from scratching their anus.

　　6. Regularly clean toys or wipe toys with 0.05% iodine solution.

　　7. Strengthen the management of water sources to avoid water pollution.

　　8. Do not defecate at will, strengthen the harmless treatment of feces, and do not use fresh feces for fertilization.

　　9. Rural areas should promote the harmless treatment of feces, and wear shoes when working in the fields.

　　10. Strengthen the management of livestock, and do not raise chickens, ducks, and geese in cities.

　　11. Kindergartens and schools should regularly examine feces to discover children with parasitic diseases early, which is conducive to thorough deworming.

　　Laboratory examination of Isospora infection:

　　1. Taking fresh feces and examining it under a microscope after concentration by zinc sulfate floatation can improve the detection rate of oocysts. The oocysts of Isospora are highly transparent and can be easily missed in direct smears. At this time, the aperture of the microscope can be narrowed until the outlines of other protozoa or bacteria in the smear are clear.

　　2. The method of fecal examination is simple, the results are intuitive, and it is generally detected in the stool during deworming treatment. The diagnosis of intestinal parasitic diseases mostly relies on finding eggs, trophozoites, and cysts in the stool. Finding these direct evidence can clearly diagnose the corresponding parasitic disease and parasitic infection.

　　One. Isosporiasis reference food therapy recipe

　　1. Ingredients: 60 grams of real soybean oil, an appropriate amount of lotus root starch.

　　2. Preparation: Take 60 grams of soybean oil, mix it with an appropriate amount of new lotus root starch to make a thin paste.

　　3. Dosage: The above is the daily amount, taken in 3 doses after being simmered and warmed.

　　Two. Isosporiasis foods to be eaten

　　1. One can eat some nutritious foods, such as eggs, tofu, fish, fresh vegetables and fruits, etc.

　　2. After deworming, one should also eat more animal liver and lean meat and other foods.

　　Three. Isosporiasis dietary taboos

　　1. Avoid fried and fried foods. This is because these foods cause the parasites to be restless and uncomfortable in the stomach, which can lead to abdominal pain. Therefore, it is not advisable to eat fragrant foods such as fried peanuts, fried bean curd, fried pork chops, grilled lamb, fried peanuts, fried sunflower seeds, and small walnuts. If abdominal pain occurs after eating, a little rice vinegar can be eaten to calm the worms.

　　2. Avoid greasy foods. Eating too much greasy food will block the middle energizer and spleen-stomach, causing malnutrition, dampness and heat, creating favorable conditions for parasites to survive in the body, so it is not advisable to eat greasy foods such as fatty meat, pork knuckle soup, greasy chicken and duck soup, lamb, etc. In addition, traditional vermifuge should be avoided when taking greasy food.

　　3. Avoid unclean things. The cause of enterobiasis is the intake of unclean things, such as vegetables and fruits contaminated with ascaris eggs, or water chestnuts, lotus roots, and lotus roots contaminated with flukes, or uncooked pork and beef with cysticerci.

　　Isosporiasis currently has no effective treatment. The first-line treatment drug is sulfamethoxazole/trimethoprim (sulfamethoxazole-trimethoprim complex), 2 tablets per time for adult patients, 4 times a day, for 10 days, then changed to 2 tablets per time, 2 times a day, and then taken for 3 weeks. Some people advocate taking sulfamethoxazole/trimethoprim (sulfamethoxazole-trimethoprim complex) 2 tablets per time, 2 times a day, for 5 days. Furosemide can also be used, 100mg per time, 4 times a day, 10 days as a course of treatment; children 6mg/(kg·d), taken in 4 doses, the course is the same as adults. Pyrimethamine plus sulfadiazine, primaquine plus chloroquine, etc., all have certain efficacy; but metronidazole, tetracycline, etc., seem to be ineffective.