Intestinal microsporidiosis with Septata intestinalis in a patient with AIDS—response to albendazole

Franzen, Caspar; Müller, Andreas; Schwenk, A.; Salzberger, Bernd; Fätkenheuer, Gerd; Mahrle, G.; Diehl, Volker; Schrappe, Matthias

doi:10.1016/s0163-4453(95)80034-4

Cited by 11 publications

(5 citation statements)

References 13 publications

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“…Encephalitozoon spp. Similar to Enterocytozoon bieneusi, E. intestinalis causes an enteritis with diarrhea, weight loss, and malabsorption (68,70,78,121,136,143,207,212,247,266). Besides intestinal infections, these parasites may infect the biliary tract and gallbladder, resulting in cholangitis and cholecystitis (385).…”

Section: Gastrointestinal and Biliary Tract Infectionsmentioning

confidence: 99%

“…Besides intestinal infections, these parasites may infect the biliary tract and gallbladder, resulting in cholangitis and cholecystitis (385). Disseminated infections occur regularly and involve heavy infections of the urinary tract including the kidneys (68,121,143,150,247,268). Left untreated, small bowel infection with E. intestinalis can lead to perforation and peritonitis (331).…”

Section: Gastrointestinal and Biliary Tract Infectionsmentioning

confidence: 99%

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Molecular Techniques for Detection, Species Differentiation, and Phylogenetic Analysis of Microsporidia

1999

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SUMMARY Microsporidia are obligate intracellular protozoan parasites that infect a broad range of vertebrates and invertebrates. These parasites are now recognized as one of the most common pathogens in human immunodeficiency virus-infected patients. For most patients with infectious diseases, microbiological isolation and identification techniques offer the most rapid and specific determination of the etiologic agent. This is not a suitable procedure for microsporidia, which are obligate intracellular parasites requiring cell culture systems for growth. Therefore, the diagnosis of microsporidiosis currently depends on morphological demonstration of the organisms themselves. Although the diagnosis of microsporidiosis and identification of microsporidia by light microscopy have greatly improved during the last few years, species differentiation by these techniques is usually impossible and transmission electron microscopy may be necessary. Immunfluorescent-staining techniques have been developed for species differentiation of microsporidia, but the antibodies used in these procedures are available only at research laboratories at present. During the last 10 years, the detection of infectious disease agents has begun to include the use of nucleic acid-based technologies. Diagnosis of infection caused by parasitic organisms is the last field of clinical microbiology to incorporate these techniques and molecular techniques (e.g., PCR and hybridization assays) have recently been developed for the detection, species differentiation, and phylogenetic analysis of microsporidia. In this paper we review human microsporidial infections and describe and discuss these newly developed molecular techniques.

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Section: Gastrointestinal and Biliary Tract Infectionsmentioning

confidence: 99%

Section: Gastrointestinal and Biliary Tract Infectionsmentioning

confidence: 99%

Molecular Techniques for Detection, Species Differentiation, and Phylogenetic Analysis of Microsporidia

1999

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“…However, most drug treatments do not fully eradicate the parasites, and preventive measures should be implemented, including the use of physical or chemical methods to destroy or inactivate infective spores present in the environment (10). The benzimidazole albendazole is a microtubule inhibitor that is effective against Encephalitozoon species of microsporidia that infect mammals; however, incomplete response and relapses have been documented (13).…”

mentioning

confidence: 99%

Effect of Three Drugs against Encephalitozoon cuniculi Infection in Immunosuppressed Mice

Lallo

Costa

Castro³

2013

Antimicrob Agents Chemother

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bMicrosporidia comprise a large group of obligate intracellular parasites. The microsporidian Encephalitozoon cuniculi causes disseminated infection in immunosuppressed patients with HIV, cancer, or transplants and in the elderly. In vivo and in vitro studies on the effectiveness of drugs are controversial. Currently, there is no effective treatment. We tested albendazole, albendazole sulfoxide, metronidazole, and cyclosporine in mice immunosuppressed with cyclophosphamide and inoculated by the intraperitoneal route with 10 7 E. cuniculi spores. One week after experimental inoculation, the mice were treated with albendazole, albendazole sulfoxide, metronidazole, and cyclosporine. Histological and morphometric analyses were performed to compare the treated groups. The state of immunosuppression was evaluated by phenotyping CD4؉ and CD8 ؉ T cells by flow cytometry. Nontreated mice showed acute disseminated and fatal encephalitozoonosis. The treatment with benzimidazoles significantly reduced infection until 30 days posttreatment (p.t.), but at 60 days p.t., the infection had recurred. Metronidazole decreased infection by a short time, and cyclosporine was not effective. All animals were immunosuppressed by all the experiments, as demonstrated by the low number of CD4 ؉ and CD8 ؉ T cells. We conclude that no drug was effective against E. cuniculi, but the benzimidazoles controlled the infection transiently.

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“…Differentiation of species of microsporidia is important because some species (S. intestinalis, Encephalitozoon spp.) respond very well to albendazole therapy, whereas for other species like E. bieneusi, no convincing therapy is available (1)(2)(3)6). DNA amplification with the described primer pair was species specific for E. bieneusi and other primer pairs, and hybridization probes may be useful for differentiating between species of microsporidia (13).…”

Section: Discussionmentioning

confidence: 92%

“…Mono-and polyclonal antisera are not yet available outside research laboratories, in part because the most important microsporidian species, Enterocytozoon bieneusi, could not be propagated in cell culture systems (10,13). The different species of microsporidia which infect humans show variable responses to therapy, and species differentiation is also important for epidemiological research (2,3,6).…”

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confidence: 99%

Detection of microsporidia (Enterocytozoon bieneusi) in intestinal biopsy specimens from human immunodeficiency virus-infected patients by PCR

et al. 1995

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Intestinal microsporidiosis has been implicated as a major cause of chronic diarrhea in human immunodeficiency virus (HIV)-infected patients. So far diagnosis depends on direct visualization of the parasites by light and transmission electron microscopy. We evaluated the diagnostic value of microsporidian DNA amplification by PCR on duodenal biopsy specimens obtained from patients with and without intestinal microsporidiosis caused by Enterocytozoon bieneusi. Thirteen HIV-infected patients (all CDC stage C3) were studied. Eight patients had intestinal microsporidiosis caused by E. bieneusi (n ‫؍‬ 6), Septata intestinalis (n ‫؍‬ 1), and Encephalitozoon cuniculi (n ‫؍‬ 1); microsporidioses were diagnosed by light microscopy of stool samples and confirmed by light and electron microscopy of intestinal biopsy specimens. Five patients had no microsporidia in their stool samples or in their intestinal biopsy specimens, as examined by light and electron microscopy. Additionally, DNA prepared from Toxoplasma gondii derived from mouse ascites was used as a further control. A 353-bp DNA fragment of the small-subunit rRNA gene could be amplified from all six biopsy specimens infected with E. bieneusi, and the nature of the PCR products was confirmed by Southern blot hybridization. No amplification of DNA fragments was seen by using DNA extracted from biopsy specimens with S. intestinalis or E. cuniculi infection or without microsporidian infection and with template DNA extracted from T. gondii. The results suggest that PCR testing of intestinal biopsy specimens may be a useful approach to diagnosing microsporidiosis in HIV-infected patients.

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Intestinal microsporidiosis with Septata intestinalis in a patient with AIDS—response to albendazole

Cited by 11 publications

References 13 publications

Molecular Techniques for Detection, Species Differentiation, and Phylogenetic Analysis of Microsporidia

Molecular Techniques for Detection, Species Differentiation, and Phylogenetic Analysis of Microsporidia

Effect of Three Drugs against Encephalitozoon cuniculi Infection in Immunosuppressed Mice

Detection of microsporidia (Enterocytozoon bieneusi) in intestinal biopsy specimens from human immunodeficiency virus-infected patients by PCR

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