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Resolution of microsporidial sinusitis and keratoconjunctivitis by itraconazole treatment
1Laboratory of Parasitology, Istituto Superiore di Sanità, Rome, Italy.
Purpose:
To report successful treatment of ocular infection caused by the microsporidium Encephalitozoon cuniculi in a person with acquired immunodeficiency syndrome (AIDS) and nasal and paranasal sinus infection.
Method:
Case report.
Results:
Microsporidial infection in a person with AIDS and with chronic sinusitis and keratoconjunctivitis was diagnosed by Weber modified trichrome stain and transmission electron microscopy. Symptoms completely resolved with itraconazole treatment (200 mg/day for 8 weeks) after albendazole therapy (400 mg/day for 6 weeks) was unsuccessful.
Conclusion:
Itraconazole can be recommended in ocular, nasal, and paranasal sinus infection caused by E. cuniculi parasites when treatment with albendazole fails.
Insights
Itraconazole successfully treated a patient with AIDS suffering from Encephalitozoon cuniculi eye and sinus infections when albendazole failed. This finding offers a new treatment option for microsporidial infections in immunocompromised individuals.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Ophthalmology
Background:
- Microsporidiosis is an opportunistic infection caused by microsporidia.
- Encephalitozoon cuniculi (E. cuniculi) can cause severe infections in individuals with acquired immunodeficiency syndrome (AIDS).
Observation:
- A patient with AIDS presented with chronic sinusitis and keratoconjunctivitis.
- Diagnosis of E. cuniculi infection was confirmed via specialized microscopy.
Findings:
- Initial treatment with albendazole (400 mg/day for 6 weeks) was unsuccessful.
- Subsequent treatment with itraconazole (200 mg/day for 8 weeks) resulted in complete resolution of ocular, nasal, and paranasal sinus symptoms.
Implications:
- Itraconazole is a viable alternative treatment for E. cuniculi infections when albendazole is ineffective.
- This case highlights the importance of considering and effectively treating microsporidial infections in immunocompromised patients.