Isospora belli infection in a patient with Hodgkin's disease: report of a case.

A 42-year-old woman with a history of documented Hodgkin's disease for 1 year presented with watery diarrhea for 6 months. She developed watery diarrhea following recurrence of the underlying disease and use of herbs. After institution of chemotherapy, watery diarrhea persisted despite remission of the underlying disease. Stool cultures and examinations for several pathogens were negative. Later, oocysts of Isopora belli were identified in the stool. The immunological status was typical of patients with Hodgkin's disease. However, HTLV-1 seropositivity and an intact skin test for delayed hypersensitivity were noted. Institution of co-trimoxazole led to prompt resolution of the gastrointestinal symptoms within the ensuing 24 hours. Later she developed recurrent isosporiasis after chemotherapy for the underlying disease, but institution of co-trimoxazole again resolved the symptoms. She remains on maintenance therapy with co-trimoxazole. Isospora belli infection should be considered in opportunistic infections in patients with Hodgkin's disease.