Detection ofEnterocytozoon bieneusiin Two Human Immunodeficiency Virus–Negative Patients with Chronic Diarrhea by Polymerase Chain Reaction in Duodenal Biopsy Specimens and Review

Abstract

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...

Zoonotic Potential of the Microsporidia

“…Although predominantly described among adults suffering from immunodeficiency due to HIV infection, E. bieneusi infections were also reported from HIV-negative patients who were immunocompromised due to an underlying disease or due to therapeutic immunosuppression when undergoing organ transplantation (119,130,197,228,229,260,318). Furthermore, a few E. bieneusi infections in HIV-negative, immunocompetent, and otherwise healthy persons that were associated with self-limited diarrhea were reported, mostly in the context of traveler's diarrhea in Europe (9,71,114,181,182,209,242,268,282,314) but also in single cases in Africa (44,131). Hence, E. bieneusi was detected by PCR in stool samples from 7 of 148 travelers with diarrhea returning to Germany (209).…”

Enterocytozoon bieneusi (microsporidia) in faecal samples from domestic animals from Galicia, Spain

“…These eukaryotic obligate intracellular protozoans have been described infecting every major animal group, especially insects, fish, and mammals (Wittner 1999). Microsporidia have been increasingly recognized as opportunistic pathogens of immunodeficient patients , especially in Aids patients but it is also becoming increasingly common in immunocompetent individuals (Gainzarain et al 1998, Lores et al 2001.…”

Production and Characterization of Monoclonal Antibodies against Enterocytozoon bieneusi Purified from Rhesus Macaques

“…E. bieneusi has also been identified in immunologically healthy patients with diarrhea (3,12,19,21,31,35) and in individuals receiving immunosuppressive therapy (15,18,26,30,34). E. bieneusi has also been described as infecting other mammalian species, including both immunologically normal and simian immunodeficiency virus (SIV)-infected macaques (Macaca mulatta, Macaca cyclopies, and Macaca nemestrina) (17,23,24,32).…”