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Updated: Feb 3, 2026
Murine Renal Transplantation Procedure
Published on: July 10, 2009
Symptomatic respiratory Encephalitozoon cuniculi infection in renal transplant recipients
Marta Kicia1, Magdalena Szydłowicz1, Kamil Cebulski1
1Department of Biology and Medical Parasitology, Wroclaw Medical University, J. Mikulicza-Radeckiego 9, 50-367 Wroclaw, Poland.
Objectives:
Encephalitozoon spp. and Enterocytozoon bieneusi are intracellular parasitic fungi from the phylum Microsporidia, which initially localize to the intestine. As opportunistic pathogens, Encephalitozoon spp. in particular can disseminate to the respiratory tract, among other locations. Patients on life-long immunosuppression are at higher risk of such infections, mostly symptomatic.
Methods:
Sputum samples and bronchial washings from 72 renal transplant recipients and 105 patients with various respiratory diseases were screened for Encephalitozoon spp. and E. bieneusi by microscopic examination and genus-specific nested PCR followed by genotyping.
Results:
A total of 8.3% (6/72) of immunosuppressed renal transplant recipients and 1.9% (2/105) of patients with various respiratory diseases, both immunocompetent and immunosuppressed, were positive for respiratory microsporidial infection. All six transplant recipients were Encephalitozoon cuniculi-positive by PCR/sequencing and five of them suffered from respiratory symptoms. The presence of microsporidial spores was also confirmed microscopically in three of the transplant recipients. Of the two immunocompetent patients with various respiratory diseases, one had an E. cuniculi infection, while the second had an E. bieneusi infection.
Conclusions:
Life-long immunosuppression in renal transplant recipients increases the risk of respiratory infection by E. cuniculi. Microsporidia should be screened in respiratory samples of these patients, particularly when they have respiratory symptoms.
Insights
Respiratory microsporidial infections, including Encephalitozoon cuniculi, are more common in renal transplant recipients due to immunosuppression. Screening respiratory samples is crucial for early diagnosis and treatment in these at-risk patients.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Immunocompromised Hosts
Background:
- Microsporidia, such as Encephalitozoon spp. and Enterocytozoon bieneusi, are opportunistic intracellular fungi.
- These pathogens typically infect the intestine but can disseminate to other organs, including the respiratory tract.
- Patients with prolonged immunosuppression, particularly renal transplant recipients, face an elevated risk of symptomatic microsporidial infections.
Purpose of the Study:
- To investigate the prevalence of respiratory microsporidial infections in renal transplant recipients and patients with respiratory diseases.
- To identify the specific microsporidia species causing respiratory infections in these populations.
- To assess the association between immunosuppression and respiratory microsporidial infections.
Main Methods:
- Screening of sputum and bronchial washing samples from 72 renal transplant recipients and 105 patients with respiratory diseases.
- Utilized microscopic examination and genus-specific nested PCR for detection.
- Employed PCR sequencing for genotyping of identified microsporidia species.
Main Results:
- Respiratory microsporidial infections were detected in 8.3% of renal transplant recipients and 1.9% of patients with respiratory diseases.
- Encephalitozoon cuniculi was identified in six transplant recipients, five of whom presented with respiratory symptoms.
- Microsporidia were confirmed microscopically in three transplant recipients and in two patients with other respiratory conditions (one E. cuniculi, one E. bieneusi).
Conclusions:
- Life-long immunosuppression significantly increases the risk of respiratory infections caused by Encephalitozoon cuniculi in renal transplant recipients.
- Routine screening for microsporidia in respiratory samples is recommended for renal transplant recipients, especially those exhibiting respiratory symptoms.
- Early detection and management of microsporidial respiratory infections are vital in immunocompromised individuals.
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