Intestinal microsporidiosis has been associated traditionally with severely immunocompromised patients with AIDS. We describe two new cases of intestinal microsporidiosis due to Enterocytozoon bieneusi in human immunodeficiency virus -negative adults. Both patients presented with chronic nonbloody diarrhea, and one had intestinal lymphangiectasia as well. Intestinal microsporidiosis was diagnosed by evaluation of stool samples, and the specific species was determined by use of polymerase chain reaction (PCR) in duodenal biopsy specimens. To our knowledge, this is the first report of confirmation of E. bieneusi in the intestinal epithelium of HIV-negative individuals by use of PCR in duodenal biopsy specimens. Cases of intestinal microsporidiosis in HIV-negative individuals reported in the English-language literature are reviewed. These two new cases along with those described previously corroborate the need to evaluate for microsporidia in HIV-negative individuals with unexplained diarrhea.Several clinicoepidemiological studies have shown that Enlast 20 years. In 1991, intestinal lymphangiectasia, a generalized congenital disorder of the lymphatic system that originates terocytozoon bieneusi is the intestinal microsporidian encountered most frequently in patients with AIDS [1 -3]. In addition, in an immunodeficient setting, was diagnosed. In 1996 he was admitted to the hospital for evaluation of diarrhea, three loose the organism is becoming increasingly common in immunocompetent individuals [2]. To date, there are reports of only bowel movements per day, and a 6-month history of right pretibial edema. Laboratory studies revealed the following valnine children [4, 5] and five adults [6 -10], all HIV-negative, who have had intestinal microsporidiosis diagnosed, and ues: lymphocyte count, 0.8 1 10 9 /L; CD4 cell count, 0.32 1 10 9 /L; CD8 cell count, 0.12 1 10 9 /L; CD4-CD8 ratio, 2.6; total E. bieneusi was identified in stool samples from 11 of them; species-level identification was not attained for the other three protein level, 40 g/L; IgG level, 1.3 mg/mL; IgA level, 0.71 mg/mL; and IgM level, 0.17 mg/mL. Delayed-type hypersensipatients [4, 8]. We report two new cases of intestinal microsporidiosis due to E. bieneusi in HIV-negative adults from Vitoria tivity skin tests showed normal responses. Serologies for antibodies to HIV-1 and HIV-2 were negative. Results of the Van (Alava, Spain), identified in stool samples as well as duodenal biopsy specimens. To our knowledge, these are the first cases de Kamer, Schilling, and D-xylose tests were indicative of intestinal malabsorption. Esophagogastroduodenoscopy of confirmation of E. bieneusi by use of PCR in the duodenal biopsy specimens of HIV-negative individuals with intestinal showed edematous folds and nonoverelevated erythematous symptoms.lesions in the third duodenal portion. Repeated routine stool cultures for detection of pathogenic bacteria (including mycobacteria) and ova and parasites and a specific Case Reports monoclonal antibody test for Cryptosporid...

Blood culture negative endocarditis (BCNE) is frequent in infective endocarditis (IE). One of the causes of BCNE is fastidious microorganisms, such as Bartonella spp. The aim of this study was to describe the epidemiologic, clinical characteristics, management and outcomes of patients with Bartonella IE from the “Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España (GAMES)”cohort. Here we presented 21 cases of Bartonella IE. This represents 0.3% of a total of 5590 cases and 2% of the BCNE from the GAMES cohort. 62% were due to Bartonella henselae and 38% to Bartonella quintana. Cardiac failure was the main presenting form (61.5% in B. hensalae, 87.5% in B. quintana IE) and the aortic valve was affected in 85% of the cases (76% in B. henselae, 100% in B. quintana IE). Typical signs such as fever were recorded in less than 40% of patients. Echocardiography showed vegetations in 92% and 100% of the patients with B. henselae and B. quintana, respectively. Culture was positive only in one patient and the remaining were diagnosed by serology and PCR. PCR was the most useful tool allowing for diagnosis in 16 patients (100% of the studied valves). Serology, at titers recommended by guidelines, only coincided with PCR in 52.4%. Antimicrobial therapy, in different combinations, was used in all cases. Surgery was performed in 76% of the patients. No in-hospital mortality was observed. One-year mortality was 9.4%. This article remarks the importance for investigating the presence of Bartonella infection as causative agent in all BCNE since the diagnosis needs specific microbiological tools and patients could benefit of a specific treatment.

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