Chronic microsporidian infection of the nasal mucosae, sinuses and conjunctivae in HIV disease.

Lacey, Charles; Clarke, Anna; Fraser, P. K.; Metcalfe, Timothy; Bonsor, G.; Curry, Alan

doi:10.1136/sti.68.3.179

Cited by 27 publications

(33 citation statements)

References 9 publications

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“…No systemic microsporidial infection was noted in any of these patients. In HIV-infected patients, in contrast, microsporidial parasites, Encephalitozoon hellem or other Encephalitozoon-like organisms, were confined to the superficial epithelial cells of the conjunctiva or cornea, associated with an inflammatory infiltrate composed mostly of neutrophils and mononuclear cells (26,32,33,48,67,68,80,113,121,132,180,183,235,251). The inflammatory reaction was generally mild or even absent.…”

Section: Lesions and Dissemination Of The Parasitementioning

confidence: 99%

“…Prevalence data on pulmonary microsporidial colonization are not available, but microsporidian-associated pulmonary illness has, infrequently, been reported (38,62,76,78,90,113,180,182,184,185,234,235). In most patients with respiratory tract microsporidial infection, intestinal and/or systemic microsporidiosis was also present.…”

Section: Respiratory Tract Microsporidiosis In Hiv Infectionmentioning

confidence: 99%

“…Nevertheless, single cases of patients in whom sinonasal Enterocytozoon bieneusi (76,90), Encephalitozoon spp. (38,76,90,113), and S. intestinalisassociated (79,182) infections were a predominant manifestation of systemic microsporidiosis have been reported. The patients experienced sinusitis and/or nasal polyposis, causing nasal obstruction and persistent mucopurulent nasal discharge.…”

Section: Respiratory Tract Microsporidiosis In Hiv Infectionmentioning

confidence: 99%

“…This advice may be particularly important in the prevention of ocular infections that may occur as a result of inoculation of conjunctival surfaces by fingers contaminated with respiratory fluids or urine. Preliminary data indicate that transmission by the aerosol route (38,62,76,79,113,180,182,184,185,234,235), particularly of Encephalitozoon hellem, might be a consideration, but further epidemiologic studies are needed before respiratory isolation would be recommended.…”

Section: Preventionmentioning

confidence: 99%

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Human microsporidial infections

et al. 1994

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Microsporidia are obligate intracellular spore-forming protozoal parasites belonging to the phylum Microspora. Their host range is extensive, including most invertebrates and all classes of vertebrates. More than 100 microsporidial genera and almost 1,000 species have now been identified. Five genera (Enterocytozoon spp., Encephalitozoon spp., Septata spp., Pleistophora sp., and Nosema spp.) and unclassified microsporidia (referred to by the collective term Microsporidium) have been associated with human disease, which appears to manifest primarily in immunocompromised persons. The clinical manifestations of microsporidiosis are diverse and include intestinal, pulmonary, ocular, muscular, and renal disease. Among persons not infected with human immunodeficiency virus, ten cases of microsporidiosis have been documented. In human immunodeficiency virus-infected patients, on the other hand, over 400 cases of microsporidiosis have been identified, the majority attributed to Enterocytozoon bieneusi, an important cause of chronic diarrhea and wasting. Diagnosis of microsporidiosis currently depends on morphological demonstration of the organisms themselves. Initial detection of microsporidia by light microscopic examination of tissue sections and of more readily obtainable specimens such as stool, duodenal aspirates, urine, sputum, nasal discharge, bronchoalveolar lavage fluid, and conjunctival smears is now becoming routine practice. Definitive species identification is made by using the specific fluorescein-tagged antibody (immunofluorescence) technique or electron microscopy. Treatment options are limited, but symptomatic improvement of Enterocytozoon bieneusi infection may be achieved with the anthelmintic-antiprotozoal drug albendazole. Preliminary observations suggest that Septata intestinalis and Encephalitozoon infections may be cured with albendazole. Progress is being made with respect to in vitro propagation of microsporidia, which is crucial for developing antimicrosporidial drugs. Furthermore, molecular techniques are being developed for diagnostic purposes, taxonomic classification, and analysis of phylogenetic relationships of microsporidia.

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Section: Lesions and Dissemination Of The Parasitementioning

confidence: 99%

Section: Respiratory Tract Microsporidiosis In Hiv Infectionmentioning

confidence: 99%

Section: Respiratory Tract Microsporidiosis In Hiv Infectionmentioning

confidence: 99%

Section: Preventionmentioning

confidence: 99%

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Human microsporidial infections

et al. 1994

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“…Las diferencias no fueron significativas, pero los autores no consideran prudente emitir ningunaconclusión al respecto porque la muestra podría no ser suficientemente representativa concluyendo que en posteriores estudios se debe ampliar el tamaño (23). Recién descrito, E. bieneusise consideraba que parasitaba solamente a los enterocitos, pero en años más recientes se ha descrito infectando la mucosa nasal, los senos paranasales, las conjuntiva~ y la uretra (9,26,27 V. corneum se encontró como agente causal de una queratitis disciforme persistente, central, infiltración parcheada recurrente del estroma anterior e iritis de 18 meses de evolución, en un paciente seronegativo para HIV.…”

Section: Enterocytozoon Bieneusiunclassified