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Pulmonary infection with microsporidia after allogeneic bone marrow transplantation

D T Teachey1, P Russo, J M Orenstein

  • 1Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. Teacheyd@email.chop.edu

Bone Marrow Transplantation
|November 25, 2003
PubMed

Insights

Microsporidiosis, a parasitic infection, is rare in bone marrow transplant patients. This case highlights the need to consider it in unexplained pulmonary infections post-transplant.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Transplant Immunology

Background:

  • Microsporidia are obligate intracellular protozoan parasites.
  • Microsporidiosis is primarily documented in Human Immunodeficiency Virus (HIV)-infected individuals.
  • Infections in solid organ transplant recipients are rare, with limited case reports.

Observation:

  • This report details the first documented case of pulmonary microsporidiosis in an allogeneic bone marrow transplant recipient in the United States.
  • The patient received a T-cell-depleted graft.
  • The patient experienced respiratory failure and passed away 63 days post-transplant.

Findings:

  • Post-mortem diagnosis was achieved through electron microscopy and Polymerase Chain Reaction (PCR) confirmation.
  • This confirms a fatal pulmonary microsporidial infection in this immunocompromised patient.

Implications:

  • Microsporidial infection should be included in the differential diagnosis for unexplained pulmonary infections in bone marrow transplant recipients.
  • Early consideration may guide diagnostic workups and potentially improve patient outcomes.
  • This case underscores the importance of recognizing opportunistic infections in immunocompromised populations, particularly after transplantation.

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