Coinfection of Toxoplasma Gondii and Intestinal Parasites among Elderly Immunocompromised Patients

Patients with cancer and hemodialysis are prone to opportunistic infections. The present research aims to examine the frequency of Toxoplasmosis and intestinal parasites in these patients.

In the present cross-sectional study, seventy stool and blood samples from immunocompromised patients (46 hemodialysis and 24 cancer patients) from Guilan Province were collected in 2017-2018. Different tests including direct smear examination and formalin-ether was conducted for the intestinal protozoan parasites. To detect coccidian parasites (e.g. Cryptosporidium spp.) Ziehl Neelsen staining was applied. The anti T.gondii antibodies were detected via ELISA method. 

Totally 6.52% and 4.16% cases of hemodialysis and cancer patients were positive for intestinal parasite infection respectively. Blastocystis hominis was only intestinal parasite that were detected in these patients. IgG anti-Toxoplasma antibody detected in 35 (76.8%) hemodialysis and 15 (62.5%) cancer patients. IgM antibody were found in 1 elderly hemodialysis patient. Mix infection (Toxoplasmosis and Blastocystis) was observed in 6.52% and 4.16% in hemodialysis and cancer patients respectively.

It is recommended to evaluate these patients for intestinal parasitic infections during hemodialysis or chemotherapy sessions. Data showed the high percentage of elderly patients were susceptible to reactivation of chronic Toxoplasmosis. Therefore, in order to refer them for early therapy or other interventions, it is important that elderly hemodialysis and cancer patients with toxoplasma infection be diagnosed and identified.