Cyclospora cayetanensis: first imported infections in Germany.

Over the last decade increasing numbers of enteritis cases have been attributed to infection with a new coccidian species that was named Cyclospora cayetanensis in 1993. Diarrhea caused by this agent is clinically indistinguishable from cryptosporidiosis, isosporiasis and microsporidiosis, but Cyclospora infections are often very prolonged (up to 15 weeks) and may cause severe weight loss. Diagnosis of infection is important because, in contrast to diarrhea caused by Cryptosporidium and microsporidia, treatment with co-trimoxazole is effective. Here we report the cases of two female patients, aged 70 and 58 years old, respectively, who suffered from severe, prolonged diarrhea after a vacati…

Value of magnification- and chromo-endoscopy compared with video-endoscopy

The ‘Difficult’ Polyp: Pitfalls for Endoscopic Removal

Adenomatous polyps are early neoplasias of colorectal cancer (adenoma-carcinoma sequence). The majority of adenomas or early invasive cancers (T1sm1) can be resected by endoscopy. Endoscopic resection techniques include classic loop polypectomy, endoscopic mucosectomy with preceding lifting of the (almost flat) lesion, endoscopic submucosal dissection and transanal microsurgical resection, an alternative to endoscopic submucosal dissection in the rectum. Endoscopic polyp removal should always aim to resect the lesion in ‘one piece’ and avoid, whenever possible, ‘piecemeal resection’. One-piece polypectomy is the basis for a precise histopathological analysis and for proving complete removal…