What's Eating You: 12 Common Intestinal Parasites - Medscape

What's Eating You: 12 Common Intestinal Parasites - Medscape

What's Eating You: 12 Common Intestinal Parasites - Medscape

Posted: 20 Nov 2018 12:00 AM PST

Microsporidia

An electron micrograph of Encephalitozoon hellem spores rupturing from a eukaryotic cell is shown above.

Microsporidia are obligate, intracellular, spore-forming parasites.[1,23] The phylum Microsporidia contains over 1200 fungal species, a large number of which cause infection in humans. Two of the most important species are Encephalitozoon hellem and E intestinalis.[24] Most infections are found in persons infected with human immunodeficiency virus (HIV), organ transplant recipients, people with diabetes, children, and the elderly.[24]

Microsporidiosis occurs through fecal-oral ingestion or inhalation of microsporidial spores via human-to-human or waterborne transmission. Patients with intestinal microsporidiosis may develop chronic, nonbloody diarrhea; weight loss; abdominal pain; nausea; vomiting; and malnourishment.[25] With dissemination, cholecystitis and renal failure, as well as infections of the muscles, brain, and respiratory tract, may occur. In rare cases, patients with HIV/acquired immunodeficiency syndrome (AIDS) may develop microsporidial keratoconjunctivitis.[26]

The diagnosis is made via stool microscopy, but this does not allow species identification.[23] Cytologic and histologic examination may also be helpful; additionally, immunofluorescence assays (IFA) and PCR assays are available. Typically, treatment with albendazole for 2-4 weeks is effective for most ocular,[26] intestinal, and disseminated microsporidiosis.[23]

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