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1995-03-04
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Document 0162
DOCN M9550162
TI Human microsporidial infections.
DT 9505
AU Weber R; Bryan RT; Schwartz DA; Owen RL; Department of Medicine,
University Hospital, Zurich, Switzerland.
SO Clin Microbiol Rev. 1994 Oct;7(4):426-61. Unique Identifier : AIDSLINE
MED/95136203
AB 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.
DE Animal Human HIV Infections/COMPLICATIONS Microscopy, Electron
Microscopy, Electron, Scanning Microspora
Infections/*COMPLICATIONS/DIAGNOSIS/*PATHOLOGY/THERAPY
Microsporida/CLASSIFICATION/*GROWTH & DEVELOPMENT/*ULTRASTRUCTURE
Support, Non-U.S. Gov't Support, U.S. Gov't, Non-P.H.S. Support, U.S.
Gov't, P.H.S. JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).