Cryptosporidiosis in a patient with Crohn's disease under anti-TNF treatment

Ulcerative Colitis (UC) and Crohn's Disease CD), are chronic inflammatory bowel diseases (IBD) which may benefit from the treatment with biologic agents which target specific cytokines involved in inflammation (1). The anti-TNF therapy is the first biologic agent used in the treatment of complicated CD (2). Although the clinical efficacy of anti-TNF agents has been proven, their use may also be associated with an increased risk of opportunistic infections caused by bacteria, viruses and parasites (3). Cryptosporidiosis is a parasitic infection caused by Cryptosporidium Spp, clinically characterized by watery diarrhea, often profuse and prolonged, abdominal pain, nausea, vomiting, and fever. Cryptosporidium is an emerging protozoan parasite and it can be transmitted to humans from animals, from humans and from contaminated food or water. Disease severity varies according to the host general health: immunocompetent patients may develop a mild, self- limiting disease, while immunocompromised patients, may have severe and persistent symptoms, with gastrointestinal, biliary or respiratory manifestations (4). Whether the use of biologic agents is associated to an increased risk of infection by Cryptosporidium Spp is not clear.