Cryptosporidium species infection causes malabsorption and severe diarrhea in immunocompromised hosts. Association of Yellow Nail Syndrome (YNS) and Cryptosporidiosis is rare and has not been reported till date. Immunity can also be affected in this case of YNS is associated with autoimmune disorders.
Here, we describe a case of persistent diarrhea in an 8 month old YNS patient. Modified Ziehl-Neelsen staining and Saffranine-Methylene blue revealed oocyts of Cryptosporidium species. Following appropriate treatment, the patient\'s symptoms improved and the patient was discharged in a hemodynamically stable condition.
Cryptosporidiosis is a significant cause of morbidity and mortality in immunocompromised patients. YNS per se as well as treatment including steroids leads to immunosuppression in individuals making them susceptible host for opportunistic infections like Cryptosporidiosis.
Clinicians should be aware of the condition and screen for Cryptosporidiosis in any immunocompromised patients with diarrheal symptoms, as parasitic infection like this are opportunistic in them.

Cyclospora spp. is an important cause of traveler\'s diarrhea or water and food-borne diarrhoeal diseases. We present an interesting but rare case report of cyclosporiasis in a 51-year-old male who had undergone renal allograft transplant six years ago. He also had a past history of tuberculosis, cytomegalovirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and hepatitis C infection and was being treated with immunosuppressants. The patient had a prolonged history of gastrointestinal manifestations with recent acute onset of watery diarrhea associated with abdominal cramps. Stool examination after modified Ziehl-Neelsen staining revealed oocysts of Cyclospora spp. The patient was successfully treated with cotrimoxazole.

To determine the routine diagnostic methods used and compare the performance in detection of oocysts of Cryptosporidium species and cysts of Giardia intestinalis in faecal samples by European specialist parasitology laboratories and European clinical laboratories. Two sets of seven formalin-preserved faecal samples, one containing cysts of Giardia intestinalis and the other, containing oocysts of Cryptosporidium, were sent to 18 laboratories. Participants were asked to examine the specimens using their routine protocol for detecting these parasites and state the method(s) used. Eighteen laboratories answered the questionnaire. For detection of Giardia, 16 of them used sedimentation/concentration followed by light microscopy. Using this technique the lower limit of detection of Giardia was 17.2 cysts/mL of faeces in the best performing laboratories. Only three of 16 laboratories used fluorescent-conjugated antibody-based microscopy. For detection of Cryptosporidium acid-fast staining was used by 14 of the 17 laboratories that examined the samples. With this technique the lower limit of detection was 976 oocysts/mL of faeces. Fluorescent-conjugated antibody-based microscopy was used by only five of the 17 laboratories. There was variation in the lower limit of detection of cysts of Giardia and oocysts of Cryptosporidium between laboratories using the same basic microscopic methods. Fluorescent-conjugated antibody-based microscopy was not superior to light microscopy under the conditions of this study. There is a need for a larger-scale multi-site comparison of the methods used for the diagnosis of these parasites and the development of a Europe-wide laboratory protocol based upon its findings.

BACKGROUND: Cryptosporidium is a protozoan parasite causes cryptosporidial diarrhea, which is typically a short-lasting benign infection, but can become severe and non-resolving in immunocompromised individuals. The aim of the present study was to determinate the prevalence of Cryptosporidium infection in livestock and humans that were in contact with livestock in Hamadan district, Iran.
METHODS: In this cross sectional study a total of 660 fecal specimens were collected; 228, 195 and 237 from humans, whom raising livestock, their calves and lambs/goats, respectively in spring 2012. Samples were concentrated by formalin-ether concentration technique and examined using cold modified Ziehl-Neelsen staining method.
RESULTS: Two (0.87%) out of 228, 25 (12.8%) out of 195 and 6 (2.5%) out of 237 fecal samples of humans, calves and lambs/goats were positive for Cryptosporidium oocysts, respectively. There was no significant relationship between the infection to Cryptosporidium and demographic variables of humans. However, Cryptosporidium infection rate was higher in diarrheic calves (OR=3.81; 95% CI: 1.30, 11.21; P=0.010).
CONCLUSIONS: Despite studies conducted in some regions of Iran that resulted in a relatively high rate of infection in humans in contact with livestock, our results showed low prevalence and low carrier status in the asymptomatic persons in Hamadan region. Because the infection in calves and lambs/goats was relatively high, these animals could be probable reservoir of infection for humans in this area.