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[Intestinal microsporidiosis. 3 cases in HIV seropositive patients]
J F Michiels1, P Hofman, M C Saint Paul
1Laboratoire d'Anatomie Pathologique, Hôpital Pasteur, CHU de Nice.
Abstract:
Three cases of intestinal microsporidiosis are reported, in acquired immunodeficiency syndrome patients, with a chronic diarrhea. The first case is associated with an intestinal cryptococcosis and with a cytomegalovirus infection and the second case was diagnosed on ileal biopsy specimen. Since the first description of Enterocytozoon bieneusi in 1985. 49 cases of intestinal microsporidiosis are reported in the literature, all in AIDS patients and the frequency of this infection is probably underrated. Prospective studies find it in 6 to 30% of cases. This parasite must be suspected in HIV seropositive patients with clinically chronic unexplained diarrhea or with intestinal atrophy.
Insights
Intestinal microsporidiosis is an opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS), often presenting as chronic diarrhea. This condition is likely underdiagnosed and should be suspected in HIV-positive individuals with persistent gastrointestinal symptoms.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Gastroenterology
Background:
- Intestinal microsporidiosis is an opportunistic infection caused by microsporidia, primarily affecting immunocompromised individuals.
- Enterocytozoon bieneusi, a common microsporidian species, was first described in 1985 and is associated with gastrointestinal illness.
Observation:
- This report details three cases of intestinal microsporidiosis in patients with acquired immunodeficiency syndrome (AIDS), all presenting with chronic diarrhea.
- Co-infections, including intestinal cryptococcosis and cytomegalovirus infection, were noted in one case.
- Diagnosis was confirmed via ileal biopsy in one of the reported cases.
Findings:
- Since 1985, 49 cases of intestinal microsporidiosis have been documented in the literature, exclusively in AIDS patients.
- Prospective studies suggest a prevalence of 6% to 30% in this patient population, indicating the infection is likely underestimated.
- The clinical presentation often includes chronic, unexplained diarrhea and intestinal atrophy.
Implications:
- Microsporidiosis should be strongly suspected in human immunodeficiency virus (HIV)-seropositive patients experiencing chronic diarrhea or intestinal atrophy.
- Increased awareness and diagnostic vigilance are crucial for timely identification and management of this opportunistic infection.
- Further research is needed to fully understand the epidemiology and clinical impact of intestinal microsporidiosis in immunocompromised individuals.