1/10. Resolution of microsporidial sinusitis and keratoconjunctivitis by itraconazole treatment.PURPOSE: To report successful treatment of ocular infection caused by the microsporidium encephalitozoon cuniculi in a person with acquired immunodeficiency syndrome (AIDS) and nasal and paranasal sinus infection. METHOD: Case report. RESULTS: Microsporidial infection in a person with AIDS and with chronic sinusitis and keratoconjunctivitis was diagnosed by Weber modified trichrome stain and transmission electron microscopy. Symptoms completely resolved with itraconazole treatment (200 mg/day for 8 weeks) after albendazole therapy (400 mg/day for 6 weeks) was unsuccessful. CONCLUSION: itraconazole can be recommended in ocular, nasal, and paranasal sinus infection caused by E. cuniculi parasites when treatment with albendazole fails.- - - - - - - - - - ranking = 1keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
2/10. Disseminated encephalitozoon cuniculi infection in a Mexican kidney transplant recipient.BACKGROUND: No cases of encephalitozoon cuniculi infection have been reported in transplant patients. methods: A 42-year-old man received a renal transplant 8 months earlier because of terminal glomerulonephritis and was admitted with cough, fever, diarrhea, abdominal pain, and colon wall thickening. While under rapamycin (2 g/day), cyclosporine A (4.4 mg/kg/day), and prednisone (100 mg/day) therapy, he developed Banff grade IB graft rejection and was treated with methylprednisolone (1 g/day) for 3 days and oral prednisone (60 mg/d). RESULTS: Microbiologic studies were inconclusive, and biopsy specimens of ileum, colon, liver, and the grafted kidney revealed numerous gram-positive microsporidia spores. Parasitophorous vacuoles containing various developing stages of Encephalitozoon were seen. Immunofluorescence studies identified the etiologic agent as E. cuniculi. albendazole therapy resulted in clinical improvement but no eradication after 10 months of follow-up. CONCLUSIONS: This report describes what is, to the authors' knowledge, the first case of disseminated E. cuniculi infection in a kidney transplant human immunodeficiency virus-negative patient from mexico.- - - - - - - - - - ranking = 0.08226739382943keywords = immunodeficiency (Clic here for more details about this article) |
3/10. Intraocular microsporidiosis due to encephalitozoon cuniculi in a patient with idiopathic CD4 T-lymphocytopenia.encephalitozoon cuniculi was documented to cause disseminated microsporidial infection including an iris tumor and endophthalmitis in an adolescent with idiopathic CD4 T-lymphocytopenia. The diagnosis was established by microscopic, serologic and molecular methods. E. cuniculi (rabbit strain) was identified from the iris tumor, as well as from urine, conjunctival, corneal, and nasal swabs. Treatment with oral albendazole led to rapid improvement. This case raises the possibility of disseminated microsporidial infection in the context of idiopathic CD4 T-lymphocytopenia and possibly advanced human immunodeficiency virus (hiv) infection, and above all the possibility of intraocular infection with E. cuniculi in humans.- - - - - - - - - - ranking = 0.08226739382943keywords = immunodeficiency (Clic here for more details about this article) |
4/10. pathology of symptomatic microsporidial (Encephalitozoon hellem) bronchiolitis in the acquired immunodeficiency syndrome: a new respiratory pathogen diagnosed from lung biopsy, bronchoalveolar lavage, sputum, and tissue culture.Encephalitozoon hellem is a recently described microsporidian associated with an expanding spectrum of clinical presentations in patients with the acquired immunodeficiency syndrome (AIDS). It is morphologically similar to encephalitozoon cuniculi, a microsporidian infection of mammals and some avians, and their differentiation rests on biochemical and antigenic analyses. This report describes a patient previously diagnosed with keratoconjunctivitis due to E hellem who subsequently was found to have respiratory tract microsporidiosis by sputum cytology. He subsequently developed pulmonary symptoms and a left lower lobe interstitial infiltrate. A bronchoalveolar lavage and transbronchial biopsy revealed microsporidial bronchiolitis, and the etiologic agent was identified as E hellem using an immunofluorescent antibody technique. Lavage fluid was successfully cultured in monkey kidney cells, and cultivated E hellem organisms were studied using immunohistochemistry as well as scanning and transmission electron microscopy. The pathologic features of this newly described cause of protozoal bronchiolitis, the role of immunofluorescent antibody examination and in vitro tissue culture for species-specific diagnosis, and the significance of microsporidial pulmonary infections in AIDS patients are discussed.- - - - - - - - - - ranking = 5keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
5/10. encephalitozoon cuniculi isolated from the urine of an AIDS patient, which differs from canine and murine isolates.A species of Encephalitozoon has been isolated from the urine of a patient with the acquired immunodeficiency syndrome and maintained in vitro in madin darby canine kidney cells. When examined by random amplified polymorphic dna polymerase chain reaction the new isolate was found to differ from E. hellem and to have amplified products in common with murine and canine E. cuniculi. However, it more closely resembled the canine than the murine isolate. sodium dodecylsulphate polyacrylamide gel electrophoresis differentiated between all three isolates of E. cuniculi, with a band at 42-45 kDa present in the murine isolate only, bands at 52 kDa present in the canine and human isolates but not the murine, and a single band at 60 kDa (murine) and 65 kDa (canine) replaced by two bands at 55 and 70 kDa in the human isolate. The 55 kDa and 70 kDa antigens were also revealed as characteristic bands of the human isolate by Western blotting. The study has thus revealed that the species encephalitozoon cuniculi is not a homogeneous entity.- - - - - - - - - - ranking = 1keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
6/10. autopsy verification of Encephalitozoon intestinalis (microsporidiosis) eradication following albendazole therapy.Microsporidian infections are increasingly recognized as an important cause of morbidity for persons infected with the human immunodeficiency virus. Encephalitozoon (formerly Septata) intestinalis is a recently described microsporidian that causes intestinal and disseminated infections in severely immunocompromised patients with acquired immunodeficiency syndrome. Several studies suggest that albendazole is an effective therapy for E intestinalis infection. However, relapses of symptoms and reappearance of microsporidian spores in diagnostic specimens have been reported following treatment in some cases. Because these results are based on examination of feces or cytologic specimens with an inherent sampling bias, it would be ideal to have autopsy data on the complete tissue evaluation of major organ systems of patients who had antemortem E intestinalis infection treated with albendazole. This report describes an acquired immunodeficiency syndrome patient with diarrhea and wasting syndrome associated with E intestinalis infection. Treatment with albendazole produced relief of his clinical symptoms and eliminated microsporidian spores in his feces. Following his death from other causes, an autopsy was performed. Comprehensive microscopic examination of all major organs revealed no evidence of residual microsporidian infection, suggesting parasitologic cure of E intestinalis with albendazole. The postmortem finding of complete clearance of microsporidia from body tissues is significant for future albendazole treatment of patients infected with E intestinalis and provides strong support for the value of the autopsy in evaluating the therapeutic efficacy of antimicrobials in emerging infections.- - - - - - - - - - ranking = 2.0822673938294keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
7/10. Immunologically confirmed disseminated, asymptomatic encephalitozoon cuniculi infection of the gastrointestinal tract in a patient with AIDS.microsporidia are obligate intracellular protozoan parasites that infect a broad range of vertebrates and invertebrates. They are increasingly recognized as human pathogens, especially in patients infected with human immunodeficiency virus (hiv). Organisms of the genus Encephalitozoon have been implicated as a major cause of disseminated microsporidian infections in persons with AIDS. Until recently, E. hellem was the only Encephalitozoon species confirmed by antigenic or nucleic acid methods to have infected humans. We describe the clinical course and morphological features of a case of disseminated microsporidian infection with encephalitozoon cuniculi in an hiv-infected patient with chronic sinusitis, rhinitis, and keratoconjunctivitis. parasites were found in conjunctival swab, nasal discharge, sputum, urine, stool, and duodenal biopsy specimens, but no pulmonary, renal, or gastrointestinal symptoms were documented. The patient was treated with albendazole (400 mg po b.i.d.), resulting in complete remission of his ocular and nasal symptoms, and microsporidian spores disappeared from all sites. To our knowledge, this case is only the second of E. cuniculi infection in humans that has been confirmed by either antibody- or nucleic acid-based methods, and it is the first in which an Encephalitozoon species has been found in the intestinal tract of a human. microsporidiosis is an important emerging opportunistic infection in hiv-infected patients and, as documented in this report, has an expanding clinicopathologic spectrum.- - - - - - - - - - ranking = 0.08226739382943keywords = immunodeficiency (Clic here for more details about this article) |
8/10. A patient with acquired immunodeficiency syndrome and untreated Encephalitozoon (Septata) intestinalis microsporidiosis leading to small bowel perforation. Response to albendazole.BACKGROUND: Encephalitozoon (Septata) intestinalis is a common disseminating opportunistic intestinal microsporidian affecting patients with acquired immunodeficiency syndrome. This microsporidian does respond to albendazole therapy. A patient with acquired immunodeficiency syndrome and chronic diarrhea presented to George washington University Hospital in January of 1996. Despite appropriate surgical specimens, no etiology had been found to explain his cholecystitis, cystitis, and enteritis 3 months previously at another hospital. DESIGN: Tissue specimens were analyzed by light microscopy, using hematoxylin-eosin and the Armed Forces Institute of pathology Brown-Brenn microsporidia stain, and by transmission electron microscopy. urine and stool specimens were analyzed by modified chromotrope 2R trichrome and chitin fluorochrome stains and by transmission electron microscopy. RESULTS: At George washington University Hospital, disseminated E intestinalis was diagnosed from duodenal biopsy, urine, and stool specimens. On the 14th day of oral albendazole therapy, a partial small bowel resection was performed to correct a perforation (air under the diaphragm). There was no enterocyte microsporidian infection at that time, only spores undergoing macrophage digestion. review of previous specimens showed severe E intestinalis cholecystitis, cystitis, and enteritis. albendazole was restarted and, after 2 weeks, the patient had negative stool and urine specimens. CONCLUSIONS: Encephalitozoon intestinalis symptomatically targets many organs, including the urinary bladder. To our knowledge, this is the first tissue-documented case of cystitis. Left untreated with albendazole, small bowel infection can lead to perforation and peritonitis.- - - - - - - - - - ranking = 6keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
9/10. Foamy macrophages in acquired immunodeficiency syndrome cholangiopathy with Encephalitozoon intestinalis.acquired immunodeficiency syndrome (AIDS) cholangiopathy is a clinical syndrome characterized by right upper quadrant pain, low-grade fever, and bile duct dilatation or papillary stenosis. Cryptosporidia and cytomegalovirus have been most commonly reported as causes of AIDS cholangiopathy, but recently microsporidia have also been recognized as a causative agent. We here report an additional case of AIDS cholangiopathy with the microsporidian Encephalitozoon (Septata) intestinalis. Because this microsporidial species can disseminate throughout the body and is susceptible to treatment by albendazole, it is important to identify and separate this organism form other causes of AIDS cholangiopathy. A key histologic feature seen in this case, which has not been observed in AIDS cholangiopathy caused by other parasitic organisms, is the presence of numerous foamy macrophages in the lamina propria, which contain the microsporidial organisms, as seen by electron microscopy. The presence of these foamy macrophages may be an important histologic clue to the presence of infection by Encephalitozoon intestinalis.- - - - - - - - - - ranking = 5keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
10/10. Dual microsporidial infection due to vittaforma corneae and Encephalitozoon hellem in a patient with AIDS.A 46-year-old human immunodeficiency virus-infected Swiss citizen living in tanzania presented with respiratory, abdominal, and urogenital complaints. Microsporidial spores were isolated from urine and a sinunasal aspirate and were propagated in MRC-5 cell cultures. Western blot analysis and riboprinting identified the sinunasal isolate as Encephalitozoon hellem. Electron microscopic investigation of the urine isolate revealed spores with diplokaryotic nuclei and five to six isofilar coils of the polar tube and sporonts with two or three diplokarya. All stages were enveloped by two membranes, corresponding to a cisterna of host endoplasmic reticulum studded with ribosomes. These characteristics have been described for the genus vittaforma. Western blot analysis of this isolate revealed a banding pattern identical to that of the vittaforma corneae reference isolate. Part of the small subunit rRNA gene was amplified, sequenced (239 base pairs), and found to be identical to that of V. corneae. This is the second isolation of V. corneae and the first description of urinary tract infection due to V. corneae in a patient with AIDS.- - - - - - - - - - ranking = 0.08226739382943keywords = immunodeficiency (Clic here for more details about this article) |
| | Next -> |