Microsporidiosis
What is microsporidiosis?
Microsporidiosis is a disease that is due to infection with microscopic organisms called microsporidia. These are small simple single-celled (protozoan) parasites that form spores. These parasites must live within other cells and are found in the intestine, liver, kidney, cornea, brain, nerves, and muscles. These spores spread to other cells or are eliminated in the stool or urine.
Microsporidia have not been studied very thoroughly as agents of disease, partly because they are quite small. They are difficult to diagnose without the aid of an electron microscope, a piece of equipment that is not in a routine diagnostic microbiology laboratory. A number of animals, including insects, birds, and mammals, can serve as reservoirs of infection for microsporidia.
How are microsporidia transmitted?
The microsporidia spores are released from the gastrointestinal and urinary tracts of infected animals. The spores are then consumed by people. Within the bowels, a spore unfolds a long, thin, coiled tube that is used to penetrate a cell. Once within the cell, the microsporidia develop and multiply.
What conditions does infection with microsporidia cause?
Although microsporidia can infect people with normal immune systems, they typically do not develop symptoms. Symptoms of microsporidiosis generally occur in people with immune deficiency. Microsporidiosis is a cause of bowel, lung, kidney, brain, sinus and eye disease in people with AIDS and other conditions that are caused by immune deficiency.
Intestinal symptoms that are caused by microsporidia infection include wasting, chronic diarrhea , and gallbladder disease. The diarrheal stools are typically watery and are not accompanied by blood in the stool or by fever.
Lung symptoms include a cough and difficult, labored breathing. A chest X-ray may show signs of inflammation, fluid, or cavities in the lungs.
Infection with microsporidia can cause blood in the urine, kidney failure, bladder inflammation, and bowel perforation. Microsporidia can also spread throughout the body to cause inflammation in the brain, pancreas, gallbladder, sinuses, and ears. Microsporidia have even been seen in muscle tissue.
Two types of microsporidial eye infection occur in patients with AIDS. The first type is infection of the cornea following an eye injury, which may result in corneal perforation and blindness. (This condition is rarely seen in persons with normal immune systems.) The second type involves inflammation of the cornea and the conjunctiva of the eye (keratoconjunctivitis) in patients with AIDS.
How is microsporidiosis diagnosed?
Stool specimens may be examined for microsporidia spores. Urine samples can also be used to detect spores when the kidney and/or bladder are involved.
The spores of certain types of microsporidia may be seen under the ordinary light microscope, but spores of other types can be difficult or impossible to identify. A powerful microscope, called an electron microscope, is needed to identify a number of types of microsporidia. An eye infection can be diagnosed by examining scrapings of the cornea using an electron microscope.
Genetic probes that are specific to certain types of microsporidia have been developed in a research setting, as has the use of the polymerase chain reaction test (PCR). Some microsporidia have been cultured in the research laboratory. These tests, however, are not yet available for routine diagnosis.
How is microsporidiosis treated?
A drug called albendazole (Albenza, Stromectol) is useful for the treatment of some, but not all types of microsporidia. Therapy for microsporidiosis must be continued indefinitely, because a relapse of symptoms is common if the drug treatment is discontinued. Thalidomide is said to be useful in the symptomatic treatment of microsporidian diarrhea that does not respond to albendazole. Eye infection with microsporidia may be treated with fumagillin eyedrops. - Microsporidiosis is a disease that is caused by small parasites called microsporidia.
- Usually, microsporidia do not cause disease in healthy people.
- In people with AIDS and other forms of immune deficiency, infection with microsporidia can cause chronic diarrhea, kidney disease, and inflammation of the sinuses and corneas.
- Diagnosing microsporidiosis requires laboratory proof.
- Treatment of the infection is continued indefinitely to prevent a relapse.
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