Five case of intestinal cryptosporidiosis with pulmonary involvement in patients with AIDS are reported. The diagnosis was based on the recognition of acid-fast oocysts in sputum or aspirated bronchial material and stool specimens. Coughing and excess secretions were present in all cases. Four patients had other associated pulmonary pathogens: two Mycobacterium tuberculosis, one Mycobacterium fortuitum and one Cytomegalovirus + Pneumocystis carinii; all of them had a previous (three cases) or simultaneous (one case) diagnosis of intestinal cryptosporidiosis, presenting with diarrhoea and vomiting. In the fifth patient Cryptosporidium was the only pulmonary pathogen found in a bronchial aspirate, and the onset of diarrhoea was 1 month after respiratory detection. Fifty-seven cases of respiratory cryptosporidiosis have been reported since 1980. In 17 of them, no other pathogen was found. Diarrhoea was present in 77% of the patients, cough in 77%, dyspnea in 58%, expectoration in 54%, fever in 45%, thoracic pain in 33%.

The seasonal distribution of cryptosporidiosis in children in Aragón, a region in northeastern Spain, was determined. Over a period of six years (October 1988 to September 1994), 10,034 stool samples from 4,508 children with gastrointestinal symptoms were analyzed for this purpose. The age of the patients ranged from 1 month to 14 years. Cryptosporidium oocysts were identified in 87 (1.93%) patients. Prevalence was highest (6.20%) in children aged 1 to 3 years old. The prevalence was significantly higher in the autumn-winter period (October to March) than in the spring-summer period (April to September) in the whole population (2.41% vs. 1.35%, p = 0.010) and in the 1- to 3-year-old age group (8.44% vs. 3.20%, p = 0.002), but not in the other age groups. A possible relationship of this pattern to attendance at child care centres is suggested.

This study determines the optimal number of faecal samples that should be examined in order to minimize the occurrence of false-negative results in the diagnosis of cryptosporidiosis using routine techniques. A total of 23,023 faecal samples from 10,870 patients submitted for parasitological examination were processed by the formalin-ethyl acetate concentration technique and stained using a modified Ziehl-Neelsen method. Cryptosporidiosis was diagnosed in 232 patients (2.13%), 44 of whom were infected by HIV, the prevalence rate in this population group being 15.54%. The increase in the number of diagnoses obtained by the examination of n and (n-1) specimens was evaluated statistically. This study found that three is the optimal number of faecal samples that should be examined when cryptosporidiosis is suspected in immunocompetent patients; whereas, only two samples are required for diagnosing this protozoosis in AIDS patients.

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This work proposes and validates a simple but effective approach to train dense semantic segmentation models from sparsely labeled data. Data and labeling collection is most costly task of semantic segmentation. Our approach needs only a few pixels per image reducing the human interaction required.