Dual Microsporidial Infection with Encephalitozoon cuniculi and Enterocytozoon bieneusi in an HIV-Postive Patient

Abstract

This report describes the first dual microsporidial infection with Encephalitozoon cuniculi and Enterocytozoon bieneusi in an HIV-positive patient. In view of clinical and epidemiological findings, our E. cuniculi isolate was deduced to be of the dog strain. The patient's occupational involvement with dogs indicates that canines should be considered as a reservoir of human infections for both microsporidial species. Furthermore, our report provides detailed clinical and radiological information on a rare case of a symptomatic pulmonary infection by E. cuniculi and its improvement after treatment with albendazole.

Concurrent Infection of the Urinary Tract with Encephalitozoon cuniculi and Enterocytozoon bieneusi in a Renal Transplant Recipient

“…Enterocytozoon bieneusi spores were also detected in the urine sample of an HIV-seronegative patient (12). In addition, disseminated infection caused by E. cuniculi accompanied by an intestinal coinfection with E. bieneusi was found in an HIV-positive patient (13). Unlike in the study by Sak et al (7), we detected microsporidia only in urine sediments but not in stool samples.…”

Zoonotic Potential of the Microsporidia

“…Seroconversion in one of three children exposed to puppies with overt encephalitozoonosis has been reported (79). In another case of an E. cuniculi infection in an HIVinfected person where no material was available for genotyping, strain III ("dog strain") was suspected to be the causative agent based on geographical (Chile) and clinical reasons and on the fact that the patient had a high risk of exposure as she was working as a pet dog groomer (328). Patient-to-patient transmission was considered to be unlikely in the only study to date investigating several patients, because these patients neither knew each other nor had obvious personal contacts such as hospitalization at the same time (73,192).…”

Induction of a Rapid and Strong Antigen-Specific Intraepithelial Lymphocyte Response during Oral Encephalitozoon cuniculi Infection

“…With the onset of the AIDS pandemic, more attention has been paid to several microsporidia species including Encephalitozoon, due to their ability to cause disease in humans (2)(3)(4)(5)(6). Because of its ability to grow in tissue culture, most of what is known about the biology of microsporidia is based on Encephalitozoon cuniculi (7).…”

“…Induction of strong gut immunity in response to E. cuniculi infection, characterized by a significant and rapid increase in the intraepithelial lymphocyte (IEL) 3 population, was observed. The immune IELs exhibited significant Ag-specific ex vivo cytotoxicity and elevated cytokine messages during infection.…”