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M94A0326.TXT
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1994-10-08
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Document 0326
DOCN M94A0326
TI Clinical features of microsporidiosis in patients with AIDS.
DT 9412
AU Asmuth DM; DeGirolami PC; Federman M; Ezratty CR; Pleskow DK; Desai G;
Wanke CA; Department of Pathology, New England Deaconess Hospital,
Boston,; Massachusetts 02215.
SO Clin Infect Dis. 1994 May;18(5):819-25. Unique Identifier : AIDSLINE
MED/94355523
AB Microsporidia are protozoan parasites responsible for significant
gastrointestinal disease in patients infected with human
immunodeficiency virus. We report the clinical features of 20 patients
with chronic diarrhea for whom microsporidian spores were identified by
modified trichrome staining of stool smears and confirmed by biopsy
and/or electron microscopy of stool. Of the 18 microsporidian protozoa
identified to the species level, 14 (78%) were Enterocytozoon bieneusi
and four (22%) were Septata intestinalis. The mean CD4 count in these
patients was 35 +/- 29 cells/mm3. Parameters of absorption, specifically
absorption of fat and D-xylose, and levels of zinc were strikingly
abnormal in patients who were tested. Treatment with albendazole led to
clinical responses in six of 10 patients, and dietary manipulation
resulted in clinical improvement in eight of nine patients. We
recommended that patients with chronic, intermittent diarrhea and CD4
counts of < 100 cells/mm3 be further evaluated for microsporidia by
modified trichrome staining of stool and light and electron microscopy
of small bowel biopsy specimens. Antiprotozoal therapies are currently
experimental, but some patients who have been treated with these
therapies have dramatic responses. We also recommend that special
attention be paid to the measurement of parameters of absorption with
appropriate modification of diet.
DE Adult Albendazole/THERAPEUTIC USE Animal AIDS-Related Opportunistic
Infections/DRUG THERAPY/EPIDEMIOLOGY/ *PARASITOLOGY
Boston/EPIDEMIOLOGY Chronic Disease Diarrhea/DIET THERAPY/DRUG
THERAPY/PARASITOLOGY Human *Intestinal Diseases, Parasitic/DRUG
THERAPY/EPIDEMIOLOGY/ PARASITOLOGY Leukocyte Count Malabsorption
Syndromes/DIET THERAPY/ETIOLOGY Male Metronidazole/THERAPEUTIC USE
*Microspora Infections/COMPLICATIONS/DRUG THERAPY/EPIDEMIOLOGY
Microsporida/*ISOLATION & PURIF Retrospective Studies T4 Lymphocytes
JOURNAL ARTICLE REVIEW REVIEW, MULTICASE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).