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Disseminated infection with encephalitozoon intestinalis in AIDS patients: report of 2 cases

Veronica Svedhem1, Marianne Lebbad, Bo Hedkvist

  • 1Department of Infectious Diseases, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden. veronica.svedhem@ks.se

Scandinavian Journal of Infectious Diseases
|October 11, 2002
PubMed

Insights

Microsporidiosis, an opportunistic infection in advanced HIV, can disseminate. Two cases show Encephalitozoon intestinalis spreading from the gut to lungs and other sites, impacting the central nervous system.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Microbiology

Background:

  • Microsporidiosis is a significant opportunistic infection in individuals with advanced Human Immunodeficiency Virus (HIV).
  • Encephalitozoon intestinalis is a microsporidian parasite that can cause disseminated infections in immunocompromised hosts.

Observation:

  • Two cases of disseminated Encephalitozoon intestinalis infection in HIV-positive patients are presented.
  • The first case involved a prolonged intestinal infection preceding dissemination, with microsporidia identified in sputum.
  • The second case demonstrated widespread dissemination with spores found in conjunctival cells, sinus lavage, sputum, and urine, alongside central nervous system involvement.

Findings:

  • Disseminated microsporidiosis, specifically by Encephalitozoon intestinalis, represents a severe complication of advanced HIV.
  • The parasite can spread from the gastrointestinal tract to multiple organs, including the respiratory system and potentially the central nervous system.
  • Successful treatment of microsporidial infection may precede or coincide with the development of other opportunistic conditions, such as cerebral lymphoma.

Implications:

  • Early recognition and diagnosis of microsporidiosis are crucial for managing opportunistic infections in advanced HIV.
  • Understanding the dissemination patterns of Encephalitozoon intestinalis can guide diagnostic approaches and therapeutic strategies.
  • The potential for co-occurrence or sequential development of other opportunistic conditions highlights the complexity of managing advanced HIV disease.

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