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Liu C, Chen Q, Fu P, Shi YY. Anncaliia algerae Microsporidiosis Diagnosed by Metagenomic Next-Generation Sequencing, China. Emerg Infect Dis 2022; 28:1466-1470. [PMID: 35731183 PMCID: PMC9239868 DOI: 10.3201/eid2807.212315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report a case of Anncaliia algerae microsporidia infection in an immunosuppressed kidney transplant recipient in China. Light microscopy and transmission electron microscopy initially failed to identify A. algerae, which eventually was detected by metagenomic next-generation sequencing. Our case highlights the supporting role of metagenomic sequencing in early identification of uncommon pathogens.
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Buppajarntham A, Atikankul T, Putaporntip C, Jongwutiwes S, Suankratay C. Myositis Caused by Trachipleistophora hominis in a Person With Human Immunodeficiency Virus: The First Case in Thailand. Open Forum Infect Dis 2021; 8:ofab494. [PMID: 34877363 PMCID: PMC8643666 DOI: 10.1093/ofid/ofab494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/27/2021] [Indexed: 11/14/2022] Open
Abstract
Background To date, cases of extraintestinal micro-sporidiosis have been increasingly reported in both otherwise healthy and immunocompromised individuals. Among them, microsporidial myositis is very rare. To the best of our knowledge, this is the first report of microsporidial myositis caused by Trachipleistophora hominis in a patient with human immunodeficiency virus (HIV) in Thailand. Case report A Thai man with HIV presented with fever and muscle pain at both anterior thighs and left arm for 3 months. Muscle biopsy was performed, and pathology exhibited neutrophil infiltration and focal aggregations of microsporidial spores. The 18S ribosomal RNA sequence revealed the species of this microsporidium as T hominis, and albendazole of 800mg/day was initiated. He gradually improved, and was discharged home 6 weeks after hospitalization. Conclusions To the best of our knowledge, this is the first report of microsporidial myositis caused by Trachipleistophora hominis in a person with HIV in Thailand.
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Affiliation(s)
- Aubonphan Buppajarntham
- Division of Infectious Diseases, Department of Medicine, Bangkok Phuket Hospital, Phuket, Thailand
| | - Taywin Atikankul
- Department of Pathology, Queen Savang Vadhana Memorial Hospital, Thai Red Cross Society, Chonburi, Thailand
| | - Chaturong Putaporntip
- Molecular Biology of Malaria and Opportunistic Parasites Research Unit, Department of Parasitology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Somchai Jongwutiwes
- Molecular Biology of Malaria and Opportunistic Parasites Research Unit, Department of Parasitology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chusana Suankratay
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Abstract
Microsporidia are obligate intracellular pathogens identified ∼150 years ago as the cause of pébrine, an economically important infection in silkworms. There are about 220 genera and 1,700 species of microsporidia, which are classified based on their ultrastructural features, developmental cycle, host-parasite relationship, and molecular analysis. Phylogenetic analysis suggests that microsporidia are related to the fungi, being grouped with the Cryptomycota as a basal branch or sister group to the fungi. Microsporidia can be transmitted by food and water and are likely zoonotic, as they parasitize a wide range of invertebrate and vertebrate hosts. Infection in humans occurs in both immunocompetent and immunodeficient hosts, e.g., in patients with organ transplantation, patients with advanced human immunodeficiency virus (HIV) infection, and patients receiving immune modulatory therapy such as anti-tumor necrosis factor alpha antibody. Clusters of infections due to latent infection in transplanted organs have also been demonstrated. Gastrointestinal infection is the most common manifestation; however, microsporidia can infect virtually any organ system, and infection has resulted in keratitis, myositis, cholecystitis, sinusitis, and encephalitis. Both albendazole and fumagillin have efficacy for the treatment of various species of microsporidia; however, albendazole has limited efficacy for the treatment of Enterocytozoon bieneusi. In addition, immune restoration can lead to resolution of infection. While the prevalence rate of microsporidiosis in patients with AIDS has fallen in the United States, due to the widespread use of combination antiretroviral therapy (cART), infection continues to occur throughout the world and is still seen in the United States in the setting of cART if a low CD4 count persists.
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Weiss LM, Takvorian PM. Anncaliia algerae. Trends Parasitol 2021; 37:762-763. [PMID: 33941494 DOI: 10.1016/j.pt.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Louis M Weiss
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine Division of Infectious Diseases, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Peter M Takvorian
- Department of Biological Sciences, Rutgers University, Newark, NJ, USA
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Nadelman DA, Bradt AR, Qvarnstrom Y, Goldsmith CS, Zaki SR, Wang F, Smith EH, Fullen DR. Cutaneous microsporidiosis in an immunosuppressed patient. J Cutan Pathol 2020; 47:659-663. [PMID: 32125011 DOI: 10.1111/cup.13674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/05/2020] [Accepted: 02/26/2020] [Indexed: 11/29/2022]
Abstract
Microsporidia are a group of obligate intracellular parasites that naturally infect domestic and wild animals. Human microsporidiosis is an increasingly recognized multisystem opportunistic infection. The clinical manifestations are diverse with diarrhea being the most common presenting symptom. We present a 52-year-old woman with a history of amyopathic dermatomyositis complicated by interstitial lung disease managed with mycophenolate mofetil and hydroxychloroquine who presented with a 7-month history of recurrent subcutaneous nodules as well as intermittent diarrhea and chronic sinusitis. A punch biopsy showed superficial and deep lymphocytic and granulomatous dermatitis with focal necrosis. Tissue stains for microorganisms revealed oval 1 to 3 μm spores within the necrotic areas in multiple tissue stains. Additional studies at the Centers for Disease Control and Prevention confirmed cutaneous microsporidiosis. This case is one of very few confirmed examples of cutaneous microsporidiosis reported in the literature.
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Affiliation(s)
| | - Ashley R Bradt
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yvonne Qvarnstrom
- Centers for Global Health, Division of Parasitic Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Cynthia S Goldsmith
- National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Sherif R Zaki
- National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Frank Wang
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily H Smith
- Department of Dermatology, University of Missouri, Columbia, Missouri, USA
| | - Douglas R Fullen
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
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Microsporidial myositis in adult-onset immunodeficiency: case-based review. Rheumatol Int 2019; 39:1995-2003. [PMID: 31501996 DOI: 10.1007/s00296-019-04439-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/31/2019] [Indexed: 10/26/2022]
Abstract
Polymyositis is a diagnosis of exclusion. In patients with odd features, it can be of infective etiology. A high index of suspicion is required for diagnosis. A 55-year-old gentleman presented with gradual-onset proximal muscle weakness. Examination revealed mild distal weakness but no rash. Muscle enzymes were raised and tests for autoantibodies were negative. Biopsy revealed microsporidiosis. In view of this unusual infection, immunodeficiency was considered and he was found to have lymphopenia which antedated his illness. Later, he developed cranial nerve palsies due to multiple lesions in the pons. In addition, he had Cytomegalovirus viremia. Literature was reviewed to identify 20 cases of microsporidial myositis, its presentation, underlying immunodeficient state, and clinical course. Infective polymyositis should be considered in a patient with paucity of clinical and serological autoimmune features. Lymphopenia can point to underlying immunodeficiency. CMV infection could be the contributor to or bystander-effect of idiopathic lymphopenia.
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Sutrave G, Maundrell A, Keighley C, Jennings Z, Brammah S, Wang MX, Pamphlett R, Webb CE, Stark D, Englert H, Gottlieb D, Bilmon I, Watts MR. Anncaliia algerae Microsporidial Myositis, New South Wales, Australia. Emerg Infect Dis 2019; 24:1528-1531. [PMID: 30014835 PMCID: PMC6056123 DOI: 10.3201/eid2408.172002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We describe the successful management of Anncaliia algerae microsporidial myositis in a man with graft versus host disease after hemopoietic stem cell transplantation. We also summarize clinical presentation and management approaches and discuss the importance of research into the acquisition of this infection and strategies for prevention.
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Infections in Heart, Lung, and Heart-Lung Transplantation. PRINCIPLES AND PRACTICE OF TRANSPLANT INFECTIOUS DISEASES 2019. [PMCID: PMC7121494 DOI: 10.1007/978-1-4939-9034-4_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Half a century has passed since the first orthotopic heart transplant took place. Surgical innovations allowed for heart, lung, and heart-lung transplantation to save lives of patients with incurable chronic cardiopulmonary conditions. The complexity of the surgical interventions, chronic host health conditions, and antirejection immunosuppressive medications makes infectious complications common. Infections have remained one of the main barriers for successful transplantation and a source of significant morbidity and mortality. Recognition of infections and its management in this setting require outstanding clinical skills since transplant recipients may not exhibit classic signs or symptoms of disease, and laboratory work has some pitfalls. The prevention, identification, and management of infectious diseases complications in this population are a priority to undertake to improve the medical outcomes of transplantation. Herein, we reviewed the historical aspects, epidemiology, and prophylaxis of infections in heart, lung, and heart-lung transplantation. We also discuss the most prevalent organisms affecting the host and the organ systems involved.
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Abstract
INTRODUCTION Microsporidia have been increasingly reported to infect humans. The most common presentation of microsporidiosis is chronic diarrhea, a significant mortality risk in immune-compromised patients. Albendazole, which inhibits tubulin, and fumagillin, which inhibits methionine aminopeptidase type 2 (MetAP2), are the two main therapeutic agents used for treatment of microsporidiosis. In addition, to their role as emerging pathogens in humans, microsporidia are important pathogens in insects, aquaculture, and veterinary medicine. New therapeutic targets and therapies have become a recent focus of attention for medicine, veterinary, and agricultural use. Areas covered: Herein, we discuss the detection and symptoms of microsporidiosis in humans and the therapeutic targets that have been utilized for the design of new drugs for the treatment of this infection, including triosephosphate isomerase, tubulin, MetAP2, topoisomerase IV, chitin synthases, and polyamines. Expert opinion: Enterocytozoon bieneusi is the most common microsporidia in human infection. Fumagillin has a broader anti-microsporidian activity than albendazole and is active against both Ent. bieneusi and Encephaliozoonidae. Microsporidia lack methionine aminopeptidase type 1 and are, therefore, dependent on MetAP2, while mammalian cells have both enzymes. Thus, MetAP2 is an essential enzyme in microsporidia and new inhibitors of this pathway have significant promise as therapeutic agents.
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Affiliation(s)
- Bing Han
- Department of Pathology, Division of Tropical Medicine and Parasitology, Albert Einstein College of Medicine, Bronx, NY 10461
| | - Louis M. Weiss
- Department of Pathology, Division of Tropical Medicine and Parasitology, Albert Einstein College of Medicine, Bronx, NY 10461
- Department of Medicine, Division of Infectious Diseases, Albert Einstein College of Medicine, Bronx, NY 10461
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Fabiani S, Fortunato S, Bruschi F. Solid Organ Transplant and Parasitic Diseases: A Review of the Clinical Cases in the Last Two Decades. Pathogens 2018; 7:pathogens7030065. [PMID: 30065220 PMCID: PMC6160964 DOI: 10.3390/pathogens7030065] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to evaluate the occurrence of parasitic infections in solid organ transplant (SOT) recipients. We conducted a systematic review of literature records on post-transplant parasitic infections, published from 1996 to 2016 and available on PubMed database, focusing only on parasitic infections acquired after SOT. The methods and findings of the present review have been presented based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. From data published in the literature, the real burden of parasitic infections among SOT recipients cannot really be estimated. Nevertheless, publications on the matter are on the increase, probably due to more than one reason: (i) the increasing number of patients transplanted and then treated with immunosuppressive agents; (ii) the “population shift” resulting from immigration and travels to endemic areas, and (iii) the increased attention directed to diagnosis/notification/publication of cases. Considering parasitic infections as emerging and potentially serious in their evolution, additional strategies for the prevention, careful screening and follow-up, with a high level of awareness, identification, and pre-emptive therapy are needed in transplant recipients.
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Affiliation(s)
- Silvia Fabiani
- Infectious Disease Department, Azienda Ospedaliera Pisana, 56124 Pisa, Italy.
- School of Infectious Diseases, Università di Pisa, 56124 Pisa, Italy.
| | - Simona Fortunato
- School of Infectious Diseases, Università di Pisa, 56124 Pisa, Italy.
| | - Fabrizio Bruschi
- School of Infectious Diseases, Università di Pisa, 56124 Pisa, Italy.
- Department of Translational Research, N.T.M.S., Università di Pisa, 56124 Pisa, Italy.
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Garcia LS, Arrowood M, Kokoskin E, Paltridge GP, Pillai DR, Procop GW, Ryan N, Shimizu RY, Visvesvara G. Practical Guidance for Clinical Microbiology Laboratories: Laboratory Diagnosis of Parasites from the Gastrointestinal Tract. Clin Microbiol Rev 2018; 31:e00025-17. [PMID: 29142079 PMCID: PMC5740970 DOI: 10.1128/cmr.00025-17] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This Practical Guidance for Clinical Microbiology document on the laboratory diagnosis of parasites from the gastrointestinal tract provides practical information for the recovery and identification of relevant human parasites. The document is based on a comprehensive literature review and expert consensus on relevant diagnostic methods. However, it does not include didactic information on human parasite life cycles, organism morphology, clinical disease, pathogenesis, treatment, or epidemiology and prevention. As greater emphasis is placed on neglected tropical diseases, it becomes highly probable that patients with gastrointestinal parasitic infections will become more widely recognized in areas where parasites are endemic and not endemic. Generally, these methods are nonautomated and require extensive bench experience for accurate performance and interpretation.
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Affiliation(s)
| | - Michael Arrowood
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Foodborne, Waterborne, and Environmental Diseases, Waterborne Disease Prevention Branch, Atlanta, Georgia, USA
| | - Evelyne Kokoskin
- Public Health Ontario, Ottawa, Ontario, Canada
- Public Health Laboratories-Ottawa, Ottawa, Ontario, Canada
| | | | - Dylan R Pillai
- Calgary Laboratory Services, Diagnostic and Scientific Centre, Calgary, Alberta, Canada
| | - Gary W Procop
- Enterprise Test Utilization and Pathology Consultative Services, Cleveland, Ohio, USA
- Molecular Microbiology, Parasitology, and Mycology Laboratories, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
| | - Norbert Ryan
- Bacteriology and Parasitology, Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute, Melbourne, Victoria, Australia
| | | | - Govinda Visvesvara
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Foodborne, Waterborne, and Environmental Diseases, Waterborne Disease Prevention Branch, Atlanta, Georgia, USA
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Finsterer J, Löscher WN, Wanschitz J, Quasthoff S, Grisold W. Secondary myopathy due to systemic diseases. Acta Neurol Scand 2016; 134:388-402. [PMID: 26915593 PMCID: PMC7159623 DOI: 10.1111/ane.12576] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2016] [Indexed: 12/27/2022]
Abstract
Background Some systemic diseases also affect the skeletal muscle to various degrees and with different manifestations. This review aimed at summarizing and discussing recent advances concerning the management of muscle disease in systemic diseases. Method Literature review by search of MEDLINE, and Current Contents with appropriate search terms. Results Secondary muscle disease occurs in infectious disease, endocrine disorders, metabolic disorders, immunological disease, vascular diseases, hematological disorders, and malignancies. Muscle manifestations in these categories include pathogen‐caused myositis, muscle infarction, rhabdomyolysis, myasthenia, immune‐mediated myositis, necrotising myopathy, or vasculitis‐associated myopathy. Muscle affection may concern only a single muscle, a group of muscles, or the entire musculature. Severity of muscle affection may be transient or permanent, may be a minor part of or may dominate the clinical picture, or may be mild or severe, requiring invasive measures including artificial ventilation if the respiratory muscles are additionally involved. Diagnostic work‐up is similar to that of primary myopathies by application of non‐invasive and invasive techniques. Treatment of muscle involvement in systemic diseases is based on elimination of the underlying cause and supportive measures. The prognosis is usually fair if the causative disorder is effectively treatable but can be fatal in single cases if the entire musculature including the respiratory muscles is involved, in case of infection, or in case of severe rhabdomyolysis. Conclusion Secondary muscle manifestations of systemic diseases must be addressed and appropriately managed. Prognosis of secondary muscle disease in systemic diseases is usually fair if the underlying condition is accessible to treatment.
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Affiliation(s)
| | - W. N. Löscher
- Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
| | - J. Wanschitz
- Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
| | - S. Quasthoff
- Department of Neurology; Graz Medical University; Graz Austria
| | - W. Grisold
- Department of Neurology; Kaiser-Franz-Josef Spital; Vienna Austria
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Boileau M, Ferreira J, Ahmad I, Lavallée C, Qvarnstrom Y, Dufresne SF. Successful Treatment of Disseminated Anncaliia algerae Microsporidial Infection With Combination Fumagillin and Albendazole. Open Forum Infect Dis 2016; 3:ofw158. [PMID: 27704013 PMCID: PMC5047403 DOI: 10.1093/ofid/ofw158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 07/19/2016] [Indexed: 11/23/2022] Open
Abstract
Anncaliia algerae myositis is a life-threatening, emerging microsporidiosis among immunocompromised hosts. We report a case of disseminated A algerae infection in a man previously treated with alemtuzumab. Due to failure of albendazole-based therapy, fumagillin was added as a novel approach to management, with a good clinical response and patient survival.
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Affiliation(s)
| | | | | | - Christian Lavallée
- Infectious Diseases and Medical Microbiology , Hôpital Maisonneuve-Rosemont, Université de Montréal , Canada
| | - Yvonne Qvarnstrom
- Division of Parasitic Diseases and Malaria , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Simon F Dufresne
- Infectious Diseases and Medical Microbiology , Hôpital Maisonneuve-Rosemont, Université de Montréal , Canada
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Patel AK, Patel KK, Chickabasaviah YT, Shah SD, Patel DJ, Narayanappa G, Kumar A. Microsporidial polymyositis in human immunodeficiency virus-infected patients, a rare life-threatening opportunistic infection: clinical suspicion, diagnosis, and management in resource-limited settings. Muscle Nerve 2015; 51:775-80. [PMID: 25388126 DOI: 10.1002/mus.24513] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2014] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Microsporidial myositis is a rare opportunistic infection that has been reported in HIV-infected and HIV-uninfected immunocompromised patients. METHODS In this study we present a retrospective analysis of 5 cases of microsporidial myositis in HIV-infected patients, including the clinical, laboratory, and histologic features, and a review of the literature. RESULTS Five young men with HIV infection [median CD4 count of 20 cells (range 14-144)/mm(3) ] who presented with signs and symptoms suggestive of myositis underwent EMG-NCV and muscle biopsy, which revealed signs compatible with microsporidial myositis. Early and aggressive treatment led to improvement in 3 patients. Two of the 5 patients died due to a delay in diagnosis, because the spores were mistaken for Candida without confirmatory stains or a high index of suspicion. CONCLUSIONS Myositis in HIV-infected patients with low CD4 counts should be evaluated using muscle biopsy. A high index of suspicion is required for early diagnosis of microsporidial myositis in HIV-infected patients. Early diagnosis and immediate, aggressive treatment are the keys to favorable outcomes in these patients.
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Affiliation(s)
- Atul K Patel
- Infectious Diseases Clinic, Vedanta Institute of Medical Sciences, Navarangpura, Ahmedabad, 380009, India
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Santiana M, Pau C, Takvorian PM, Cali A. Analysis of the beta-tubulin gene and morphological changes of the microsporidium Anncaliia algerae both suggest albendazole sensitivity. J Eukaryot Microbiol 2014; 62:60-8. [PMID: 25105446 DOI: 10.1111/jeu.12160] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 05/27/2014] [Accepted: 07/08/2014] [Indexed: 11/29/2022]
Abstract
The Microsporidium, Anncaliia algerae, an obligate intracellular parasite, has been identified as an opportunistic human pathogen, but treatment has not been evaluated for infections with this organism. Albendazole, an antitubulin polymerization drug used against parasitic worm infections, has been the medication of choice used to treat some microsporidial infections affecting humans, with varying results ranging from clearing infection (Encephalitozoon) to resistance (Enterocytozoon). This study illustrates the effect of albendazole treatment on A. algerae infection in Rabbit Kidney (RK13) cells and Human Fetal Lung (HFL-1) fibroblasts. Albendazole appears to have an attenuating effect on A. algerae infection and albendazole's IC50 in RK13 cells is 0.1 μg/ml. Long-term treatment inhibits up to 98% of spore production, but interrupting treatment reestablishes the infection without new exposure to the parasite as supported by microscopic observations. The parasite's beta-tubulin gene was purified, cloned, and sequenced. Five of the six specific amino acids, associated with benzimidazole sensitivity, are conserved in A. algerae. These findings suggest that A. algerae is sensitive to albendazole; however, the organism is not completely cleared from cultures.
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16
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Watts MR, Chan RCF, Cheong EYL, Brammah S, Clezy KR, Tong C, Marriott D, Webb CE, Chacko B, Tobias V, Outhred AC, Field AS, Prowse MV, Bertouch JV, Stark D, Reddel SW. Anncaliia algerae microsporidial myositis. Emerg Infect Dis 2014; 20:185-91. [PMID: 24447398 PMCID: PMC3901472 DOI: 10.3201/eid2002.131126] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The insect microsporidian Anncaliia algerae was first described in 2004 as a cause of fatal myositis in an immunosuppressed person from Pennsylvania, USA. Two cases were subsequently reported, and we detail 2 additional cases, including the only nonfatal case. We reviewed all 5 case histories with respect to clinical characteristics, diagnosis, and management and summarized organism life cycle and epidemiology. Before infection, all case-patients were using immunosuppressive medications for rheumatoid arthritis or solid-organ transplantation. Four of the 5 case-patients were from Australia. All diagnoses were confirmed by skeletal muscle biopsy; however, peripheral nerves and other tissues may be infected. The surviving patient received albendazole and had a reduction of immunosuppressive medications and measures to prevent complications. Although insects are the natural hosts for A. algerae, human contact with water contaminated by spores may be a mode of transmission. A. algerae has emerged as a cause of myositis, particularly in coastal Australia.
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Desoubeaux G, Maakaroun-Vermesse Z, Lier C, Bailly É, Morio F, Labarthe F, Bernard L, Chandenier J. Successful treatment with fumagillin of the first pediatric case of digestive microsporidiosis in a liver-kidney transplant. Transpl Infect Dis 2013; 15:E250-9. [DOI: 10.1111/tid.12158] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 08/13/2013] [Accepted: 09/17/2013] [Indexed: 11/30/2022]
Affiliation(s)
- G. Desoubeaux
- Service de Parasitologie - Mycologie - Médecine tropicale; CHU de Tours; Tours France
- Faculté de Médecine; Université François Rabelais; CEPR UMR INSERM U1100/E.A. 6305; Tours France
| | - Z. Maakaroun-Vermesse
- Service de Médecine Interne et Maladies Infectieuses; CHU de Tours; Tours France
- Service de Médecine Pédiatrique; CHU de Tours; Tours France
| | - C. Lier
- Service de Parasitologie - Mycologie - Médecine tropicale; CHU de Tours; Tours France
| | - É. Bailly
- Service de Parasitologie - Mycologie - Médecine tropicale; CHU de Tours; Tours France
| | - F. Morio
- Laboratoire de Parasitologie et Mycologie Médicale; CHU de Nantes; Nantes France
- IICiMed/E.A. 1155; Université de Nantes; Nantes France
| | - F. Labarthe
- Service de Médecine Pédiatrique; CHU de Tours; Tours France
- Faculté de Médecine; Université François Rabelais; N2C INSERM U1069; Tours France
| | - L. Bernard
- Faculté de Médecine; Université François Rabelais; CEPR UMR INSERM U1100/E.A. 6305; Tours France
- Service de Médecine Interne et Maladies Infectieuses; CHU de Tours; Tours France
| | - J. Chandenier
- Service de Parasitologie - Mycologie - Médecine tropicale; CHU de Tours; Tours France
- Faculté de Médecine; Université François Rabelais; CEPR UMR INSERM U1100/E.A. 6305; Tours France
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Key Diagnostic Features of Granulomatous Interstitial Nephritis Due to Encephalitozoon cuniculi in a Lung Transplant Recipient. Am J Surg Pathol 2013; 37:447-52. [DOI: 10.1097/pas.0b013e31827e1968] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Parasitism, aptly defined as one of the 'living-together' strategies (Trager, 1986), presents a dynamic system in which the parasite and its host are under evolutionary pressure to evolve new and specific adaptations, thus enabling the coexistence of the two closely interacting partners. Microsporidia are very frequently encountered obligatory intracellular protistan parasites that can infect both animals and some protists and are a consummate example of various aspects of the 'living-together' strategy. Microsporidia, relatives of fungi in the superkingdom Opisthokonta, belong to the relatively small group of parasites for which the host cell cytoplasm is the site of both reproduction and maturation. The structural and physiological reduction of their vegetative stage, together with the manipulation of host cell physiology, enables microsporidia to live in the cytosolic environment for most of their life cycle in a way resembling endocytobionts. The ability to form structurally complex spores and the invention and assembly of a unique injection mechanism enable microsporidia to disperse within host tissues and between host organisms, resulting in long-lasting infections. Microsporidia have adapted their genomes to the intracellular way of life, evolved strategies how to obtain nutrients directly from the host and how to manipulate not only the infected cells, but also the hosts themselves. The enormous variability of host organisms and their tissues provide microsporidian parasites a virtually limitless terrain for diversification and ecological expansion. This review attempts to present a general overview of microsporidia, emphasising some less known and/or more recently discovered facets of their biology.
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