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Pulmonary microsporidial infection in a patient with CML undergoing allogeneic marrow transplant
R Kelkar1, P S Sastry, S S Kulkarni
1Department of Medical Oncology/Division of Microbiology, Tata Memorial Hospital, Parel, Bombay, India.
Abstract:
Very few cases of human microsporidial infection have been reported. The advent of AIDS has changed this. There is increasing recognition that microsporidia are important opportunistic pathogens. However, the number of cases reported in the non-HIV population is small. We report here a case of microsporidial infection in a female patient with chronic myeloid leukemia undergoing allogeneic bone marrow transplantation. There was also an associated fungal infection. The diagnosis could be reached only after postmortem and was confirmed by electron micrography. We suggest that transplant patients are another group of patients who are susceptible to this group of opportunistic pathogens.
Insights
Microsporidial infections are rare but increasingly recognized as opportunistic pathogens, especially in immunocompromised individuals. This case highlights their potential in transplant patients, even without HIV.
Area of Science:
- Infectious Diseases
- Immunology
- Hematology
Background:
- Microsporidia are increasingly recognized as opportunistic pathogens, particularly in individuals with Acquired Immunodeficiency Syndrome (AIDS).
- Human microsporidial infections are infrequently reported, especially in non-HIV populations.
- Allogeneic bone marrow transplantation creates a state of profound immunosuppression, potentially increasing susceptibility to opportunistic infections.
Observation:
- A female patient with chronic myeloid leukemia undergoing allogeneic bone marrow transplantation developed a microsporidial infection.
- The patient also had an associated fungal infection.
- Diagnosis of microsporidial infection was only achieved postmortem via electron micrography.
Findings:
- This case demonstrates microsporidial infection in an immunocompromised patient without HIV, specifically following allogeneic bone marrow transplantation.
- The co-occurrence of fungal infection suggests a broader susceptibility to opportunistic pathogens in this patient group.
- Electron micrography is a crucial diagnostic tool for identifying microsporidia, particularly in challenging postmortem cases.
Implications:
- Allogeneic bone marrow transplant recipients represent a potentially susceptible population for microsporidial infections.
- Increased vigilance and diagnostic efforts for microsporidiosis are warranted in transplant patients.
- Understanding the spectrum of opportunistic pathogens in immunocompromised hosts is critical for improving patient outcomes.