5.2.4.7 Blastocystosis

Blastocystis hominis belongs to an anaerobic parasite of uncertain taxonomy found in the human digestive tract, causing diarrhea when heavily infected. Vacuolated

### Figure 36.

Cryptosporidiosis (upper panels, ileal mucosal biopsy from a young suffering from severe diarrhea after close contact with cows in a Hokkaido farm; lower panels, autopsied jejunum of an AIDS patient complaining of lethal diarrhea; left, H&E; right, reactivity with the serum of a cryptosporidiosis patient with high-titer IgG). The tiny microbes grow in the brush border of enterocytes (arrows). Immunostaining using the high-titer serum demonstrates dot-like positive signals on the apex of the columnar cells of both patients.

Low-Specificity and High-Sensitivity Immunostaining for Demonstrating Pathogens… DOI: http://dx.doi.org/10.5772/intechopen.85055

#### Figure 37.

5.2.4.5 Cryptosporidiosis

Immunohistochemistry - The Ageless Biotechnology

5.2.4.6 Cystoisosporiasis

5.2.4.7 Blastocystosis

Figure 36.

98

Cryptosporidiosis is zoonotic and waterborne infection of Cryptosporidium parvum, preferentially involving small bowel mucosa. In immunocompetent individuals, selflimiting watery diarrhea occurs, while in AIDS patients, the infection provokes lifethreatening intractable diarrhea without effective therapeutic agents in hand [60]. The high-titer patient serum was chosen from a stock of 1994 mass infection of C. parvum due to contamination in the water supply system, taking place in Hiratsuka, Kanagawa, Japan. Biopsy was performed from the terminal ileal mucosa of high school boy who complained of severe diarrhea after close contact with cows in a Hokkaido farm during the summer vacation. A Japanese AIDS patient died of intractable diarrhea, and autopsy revealed cryptosporidiosis on the small bowel mucosa. Immunostaining using the high-titer serum clearly demonstrated small dot-like positive signals along the brush border of the small bowel mucosa of both patients (Figure 36) [21–23].

Cystoisospora (formerly called Isospora) belli infection causes intractable diarrhea in individuals who live in or have traveled to tropical poor sanitary areas. Infection in

Blastocystis hominis belongs to an anaerobic parasite of uncertain taxonomy found in

Cryptosporidiosis (upper panels, ileal mucosal biopsy from a young suffering from severe diarrhea after close contact with cows in a Hokkaido farm; lower panels, autopsied jejunum of an AIDS patient complaining of lethal diarrhea; left, H&E; right, reactivity with the serum of a cryptosporidiosis patient with high-titer IgG). The tiny microbes grow in the brush border of enterocytes (arrows). Immunostaining using the high-titer serum

demonstrates dot-like positive signals on the apex of the columnar cells of both patients.

the human digestive tract, causing diarrhea when heavily infected. Vacuolated

immunocompromised patients, particularly AIDS patients in Africa, is lifethreatening [61]. C. belli-induced acalculous cholecystitis is a noteworthy finding [62]. Duodenal biopsy specimen was taken from a Japanese male patient with adult T-cell leukemia in Kyushu Island. Chronic active inflammation with villous atrophy represented intractable diarrhea seen in this patient. Large-sized schizonts of C. belli were observed among the columnar cells in H&E preparations, and they were visualized by immunostaining using the patient's own serum (Figure 37) [21, 23].

Cystoisosporiasis (left, H&E; right, reactivity with patient's own serum). Duodenal biopsy specimen was taken from a Japanese male patient with adult T-cell leukemia in Kyushu Island, complaining of severe diarrhea. Large-sized schizonts of Cystoisospora belli are scattered among the columnar cells (arrows). Immunostaining using patient's own serum decorates the microbe.

morphology and size variation are characteristic [63]. We encountered a patient with diarrhea and high-titer serum antibody to B. hominis [64]. The target of immunostaining was formalin-fixed, paraffin-embedded cell block preparations of cultured B. hominis. Cell wall positivity was clearly observed, as shown in Figure 38 [21–23].

## 5.2.5 Helminthic infection

### 5.2.5.1 Gnathostomiasis

Infestation of Gnathostoma happens after eating undercooked or raw freshwater fish, frogs, birds, and reptiles, and migratory swelling of the skin (creeping disease) follows [65]. Cut surface of G. hispidum was identified in targeted abdominal skin biopsy from creeping disease, seen in a Japanese male patient aged 60's. The larval body is histologically featured by spiculated cuticles, well-developed muscle cells

#### Figure 38.

Blastocystosis (cultured Blastocystis hominis in cell block preparation: left, H&E; right, reactivity with the serum of a patient with serologically proven high-titer IgG). Cultured B. hominis reveals vacuolated morphology and size variation. The centrifuged pellet was fixed in formalin and embedded in paraffin to prepare cell blocks. The cell wall of the microbes is immunostained with the serum of a patient with diarrhea and high-titer serum antibody to B. hominis.

### Figure 39.

Gnathostomiasis (left, H&E; right, reactivity with patient's own serum). A Japanese male manifested creeping disease on the abdomen. Targeted biopsy reveals cut surfaces of Gnathostoma hispidum in the dermis. The larval body is histologically featured by spiculated cuticles, well-developed muscle cells with clear cytoplasm, eosinophilic lateral chords, and the centrally located gut. The patient's serum was solely reactive with the gut cells.

with clear cytoplasm, eosinophilic lateral chords, and the centrally located gut. The patient's serum was solely reactive with the gut cells (Figure 39) [21, 23].
