Parasitic Sinusitis and Otitis in Patients Infected with Human Immunodeficiency Virus: Report of Five Cases and Review

Dunand, Viviane A.; Hammer, Scott M.; Rossi, R; Poulin, Muriel A.; Albrecht, Mary; Doweiko, John P.; DeGirolami, Paola C.; Coakley, Eoin; Piessens, Eva; Wanke, Christine

doi:10.1086/514536

Cited by 77 publications

(46 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In IC patients, Acanthamoeba infections also occur in the skin (386) and bones (512). Rhinosinusitis (401,477), keratitis (251,318,358), otitis (185,513), vasculitis (260,486), and endophthalmitis (259) have also been reported for Acanthamoeba-HIVcoinfected patients. Skin lesions are the most common presenting manifestation of Acanthamoeba in AIDS (377) and may be present in the absence of CNS involvement (551).…”

Section: Free-living Amoebaementioning

confidence: 99%

Importance of Nonenteric Protozoan Infections in Immunocompromised People

et al. 2010

View full text Add to dashboard Cite

SUMMARY There are many neglected nonenteric protozoa able to cause serious morbidity and mortality in humans, particularly in the developing world. Diseases caused by certain protozoa are often more severe in the presence of HIV. While information regarding neglected tropical diseases caused by trypanosomatids and Plasmodium is abundant, these protozoa are often not a first consideration in Western countries where they are not endemic. As such, diagnostics may not be available in these regions. Due to global travel and immigration, this has become an increasing problem. Inversely, in certain parts of the world (particularly sub-Saharan Africa), the HIV problem is so severe that diseases like microsporidiosis and toxoplasmosis are common. In Western countries, due to the availability of highly active antiretroviral therapy (HAART), these diseases are infrequently encountered. While free-living amoebae are rarely encountered in a clinical setting, when infections do occur, they are often fatal. Rapid diagnosis and treatment are essential to the survival of patients infected with these organisms. This paper reviews information on the diagnosis and treatment of nonenteric protozoal diseases in immunocompromised people, with a focus on patients infected with HIV. The nonenteric microsporidia, some trypanosomatids, Toxoplasma spp., Neospora spp., some free-living amoebae, Plasmodium spp., and Babesia spp. are discussed.

show abstract

Section: Free-living Amoebaementioning

confidence: 99%

Importance of Nonenteric Protozoan Infections in Immunocompromised People

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Acanthamoeba spp. also have been associated with cutaneous lesions and sinusitis in AIDS patients and other immunocompromised individuals (128,143,164,179,282,295,446). The first suggestion that Acanthamoeba could cause disease in humans came in 1958 during polio vaccine safety trials.…”

Section: Introductionmentioning

confidence: 99%

Acanthamoebaspp. as Agents of Disease in Humans

2003

View full text Add to dashboard Cite

Acanthamoeba spp. are free-living amebae that inhabit a variety of air, soil, and water environments. However, these amebae can also act as opportunistic as well as nonopportunistic pathogens. They are the causative agents of granulomatous amebic encephalitis and amebic keratitis and have been associated with cutaneous lesions and sinusitis. Immuno compromised individuals, including AIDS patients, are particularly susceptible to infections with Acanthamoeba. The immune defense mechanisms that operate against Acanthamoeba have not been well characterized, but it has been proposed that both innate and acquired immunity play a role. The ameba's life cycle includes an active feeding trophozoite stage and a dormant cyst stage. Trophozoites feed on bacteria, yeast, and algae. However, both trophozoites and cysts can retain viable bacteria and may serve as reservoirs for bacteria with human pathogenic potential. Diagnosis of infection includes direct microscopy of wet mounts of cerebrospinal fluid or stained smears of cerebrospinal fluid sediment, light or electron microscopy of tissues, in vitro cultivation of Acanthamoeba, and histological assessment of frozen or paraffin-embedded sections of brain or cutaneous lesion biopsy material. Immunocytochemistry, chemifluorescent dye staining, PCR, and analysis of DNA sequence variation also have been employed for laboratory diagnosis. Treatment of Acanthamoeba infections has met with mixed results. However, chlorhexidine gluconate, alone or in combination with propamidene isethionate, is effective in some patients. Furthermore, effective treatment is complicated since patients may present with underlying disease and Acanthamoeba infection may not be recognized. Since an increase in the number of cases of Acanthamoeba infections has occurred worldwide, these protozoa have become increasingly important as agents of human disease

show abstract

“…E. bieneusi-associated microsporidiosis is most frequently confined to the small intestine and results in diarrhea followed by weight loss; however, infections could also be asymptomatic (7,13,27). Intestinal microsporidiosis is a serious, insidious disease of HIV/ AIDS patients and frequently progresses to extraintestinal infections, i.e., urinary, respiratory, disseminated systemic infections, sinusitis, otitis, and keratoconjunctivitis (9,14,22,30,32). Microsporidia are on the Contaminant Candidate List of the U.S. Environmental Protection Agency because their transmission routes are not fully known, spore removal and inactivation in drinking water and parasite identification in clinical samples is technologically challenging (29), and infections in humans are difficult to treat (5,13).…”

Section: Resultsmentioning

confidence: 99%

Retrospective Species Identification of Microsporidian Spores in Diarrheic Fecal Samples from Human Immunodeficiency Virus/AIDS Patients by Multiplexed Fluorescence In Situ Hybridization

et al. 2007

View full text Add to dashboard Cite

In order to assess the applicability of multiplexed fluorescence in situ hybridization (FISH) assay for the clinical setting, we conducted retrospective analysis of 110 formalin-stored diarrheic stool samples from human immunodeficiency virus (HIV)/AIDS patients with intestinal microsporidiosis collected between 1992 and 2003. The multiplexed FISH assay identified microsporidian spores in 94 of 110 (85.5%) samples: 49 (52.1%) were positive for Enterocytozoon bieneusi, 43 (45.8%) were positive for Encephalitozoon intestinalis, 2 (2.1%) were positive for Encephalitozoon hellem, and 9 samples (9.6%) contained both E. bieneusi and E. intestinalis spores. Quantitative spore counts per ml of stool yielded concentration values from 3.5 ؋ 10 3 to 4.4 ؋ 10 5 for E. bieneusi (mean, 8.8 ؋ 10 4 /ml), 2.3 ؋ 10 2 to 7.8 ؋ 10 4 (mean, 1.5 ؋ 10 4 /ml) for E. intestinalis, and 1.8 ؋ 10 2 to 3.6 ؋ 10 2 for E. hellem (mean, 2.7 ؋ 10 2 /ml). Identification of microsporidian spores by multiplex FISH assay was more sensitive than both Chromotrope-2R and CalcoFluor White M2R stains; 85.5% versus 72.7 and 70.9%, respectively. The study demonstrated that microsporidian coinfection in HIV/AIDS patients with intestinal microsporidiosis is not uncommon and that formalin-stored fecal samples older than 10 years may not be suitable for retrospective analysis by techniques targeting rRNA. Multiplexed FISH assay is a reliable, quantitative fluorescence microscopy method for the simultaneous identification of E. bieneusi, E. intestinalis, and E. hellem, as well as Encephalitozoon cuniculi, spores in fecal samples and is a useful tool for assessing spore shedding intensity in intestinal microsporidiosis. The method can be used for epidemiological investigations and applied in clinical settings.

show abstract

Parasitic Sinusitis and Otitis in Patients Infected with Human Immunodeficiency Virus: Report of Five Cases and Review

Cited by 77 publications

References 4 publications

Importance of Nonenteric Protozoan Infections in Immunocompromised People

Importance of Nonenteric Protozoan Infections in Immunocompromised People

Acanthamoebaspp. as Agents of Disease in Humans

Retrospective Species Identification of Microsporidian Spores in Diarrheic Fecal Samples from Human Immunodeficiency Virus/AIDS Patients by Multiplexed Fluorescence In Situ Hybridization

Contact Info

Product

Resources

About