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Multiorgan microsporidiosis: report of five cases and review

G Gunnarsson1, D Hurlbut, P C DeGirolami

  • 1Department of Medicine, New England Deaconess Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|July 1, 1995
PubMed

Insights

Multiorgan microsporidiosis, often seen in adults with AIDS, affects organs like the intestines and eyes. Different species, such as Enterocytozoon bieneusi and Septata intestinalis, show distinct patterns of infection, influencing treatment strategies.

Area of Science:

  • Infectious Diseases
  • Medical Mycology
  • Parasitology

Background:

  • Microsporidiosis is an opportunistic infection caused by microsporidia, obligate intracellular protozoan parasites.
  • Multiorgan involvement is a severe manifestation, particularly in immunocompromised individuals, notably those with acquired immunodeficiency syndrome (AIDS).

Observation:

  • This study reviews five new cases and 34 previously reported cases of multiorgan microsporidiosis.
  • Commonly affected organs include the small intestine, urinary tract, biliary tree, and eyes, with less frequent involvement of the respiratory tract, nasal sinuses, and central nervous system.
  • Clinical presentation varies, ranging from asymptomatic cases to symptoms directly related to the affected organs.

Findings:

  • Enterocytozoon bieneusi (E. bieneusi) typically causes localized intestinal and hepatobiliary infections, suggesting local spread.
  • Septata intestinalis (S. intestinalis) demonstrates a propensity for widespread dissemination, indicative of hematogenous or lymphatic spread.
  • Distinct tissue tropisms were observed among different microsporidial species, impacting the pattern of organ involvement.

Implications:

  • Treatment strategies for multiorgan microsporidiosis should be tailored based on the specific microsporidial species and the organs affected.
  • Further research is essential to elucidate the pathogenic mechanisms, routes of transmission, and effective therapeutic agents for microsporidiosis.

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