Immunocompromised patients with pulmonary tuberculosis; a susceptible group to intestinal parasites.

Aim: To investigate the presence of intestinal parasites in tuberculosis patients who suffered from immunodeficiency disorders.

Background: Tuberculosis is an important infectious disease that is endemic in some regions of Iran. However, there is a coverage in the endemicity areas of this infection with intestinal parasites.

Methods: Stool samples were collected from 50 immunocompromised tuberculosis patients. Direct smear using the normal saline (0.85% NaCl solution) and Lugol's iodine staining were performed to detect trophozoite of parasites. Moreover, stool samples were concentrated using routine formalin-ether to detect protozoan cysts and helminth's ova/larvae. Specific staining techniques including Trichrome, Modified Ziehl-Neelsen and chromotrope 2R were employed to detect amoeba, Giardia spp., coccidian parasites and microsporidia.

Results: From 50 participants, 42 (84%) and 8 (16%) were male and female, respectively. The mean age + SD of patients was 47.88 + 10.88 years. Among the participated patients, HIV positive, cancer, organ transplant and receiving corticosteroids were seen in 13, 10, 15 and 12 subjects, respectively. The prevalence of Intestinal parasites was 34 %( 17/50). Blastocystis (18%; 9/50), and intestinal helminth ( Enterobius vermicularis ) (2%; 1/50) were the most prevalent and less prevalent parasites, respectively. Statistical significance difference was not seen between presence of intestinal parasites and type of immunodeficiency.

Conclusion: Our findings showed the high prevalence of intestinal parasites with majority of Blastocystis . Indeed, this study suggested that due to complicated immune conditions of TB patients with immunodeficiency disorders, this group of patients are at higher risk of infection by intestinal parasites.