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Disseminated infection due to Encephalitozoon cuniculi in a patient with AIDS: case report and review

S Fournier1, O Liguory, C Sarfati

  • 1Department of Infectious Diseases, Saint-Louis Hospital, Paris, France.

HIV Medicine
|December 12, 2001
PubMed
Abstract

Insights

Disseminated Encephalitozoon cuniculi infections occur in AIDS patients, often affecting multiple organs. Albendazole treatment shows promise, with most patients improving and microsporidia clearing from urine.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Immunocompromised Hosts

Background:

  • Microsporidia, including Encephalitozoon cuniculi, are increasingly recognized as opportunistic pathogens in individuals with Acquired Immunodeficiency Syndrome (AIDS).
  • Disseminated microsporidial infections pose a significant clinical challenge in severely immunocompromised populations.

Observation:

  • A case of disseminated Encephalitozoon cuniculi infection in an AIDS patient is presented.
  • Literature review of 12 cases revealed common multi-organ involvement (kidneys, sinuses, lungs, brain, conjunctiva) and presence of microsporidia in urine samples.
  • Asymptomatic infections were noted in a subset of patients.

Findings:

  • Light microscopy of urine samples effectively detected microsporidia in all reported cases.
  • Genotypic methods and transmission electron microscopy were used for species identification.
  • Albendazole therapy led to clinical improvement and spore clearance in a majority of treated patients, though relapses occurred.

Implications:

  • Encephalitozoon cuniculi infection should be considered in HIV-infected patients with multi-organ disease, fever, and renal failure.
  • Urine microscopy is a valuable diagnostic tool for detecting microsporidia.
  • Albendazole demonstrates therapeutic efficacy for disseminated microsporidiosis in immunocompromised individuals.

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