Medical Microbiology

Occurrence:

InHIVpatients,butlessfrequentthanEnterocytozoonbieneusi;(inaGer-

manstudythispathogenwasfoundin 2 %of 97 patients).Thereisuncon-

firmedevidenceofanimalreservoirs.

Localization:

Mainlyinthesmallintestine,inenterocytes,laminapropria,fibroblasts,

macrophages,andendothelialcells,alsofounddisseminated,forinstancein

bileducts,airways,andthekidneys.Withinhostcelllocatedin“chambers,”

separatedoffbysepta(hencetheearliernameSeptata).

Symptoms:

ChronicdiarrheaaswithE.bieneusi,othersymptomsasperorganloca-

lization.Diagnosis:sporedetectioninurineorstool,sporessomewhatlarger

thaninE.bieneusi(1.5–2.0!1. 0 – 1. 2 lm);fourtosevenpolartubulewindings.

&Encephalitozooncuniculi

Occurrence:

Worldwide;occurfrequentlyindomesticandwildrabbits,alsodescribed

inmanyotheranimalspecies(rodents,dogs,cats,foxes,monkeys);rarely

foundinHIVpatients.Ofthethreeknownpathogenicstrains,two(rabbit

anddogstrain)havealsobeenfoundinhumans(=zoonosis).

Localizationandsymptoms:

Intracellulardevelopmentinparasitophorousvacuoles.Inrabbitsmainly

inrenaltubuliandCNS.InHIVpatientswithdisseminatedinfectioncausing

hepatitis,peritonitis,nephritis,pneumonia,sinusitis,andencephalitis.

Diagnosis:

Sporedetectioninurineandorganspecimens.Spores2.5–3.2!1. 2 – 1. 6 lm

withfourtosixpolartubulewindings,morphologicallyindistinguishable

fromE.hellemspores(seeE.hellem).

&Encephalitozoonhellem

Occurrence:

Rare,inHIVpatients.

Localizationandsymptoms:

Keratoconjunctivitis,sinusitis,bronchitis,pneumonia,nephritis,urinary

tractinfection,disseminatedinfection.

Diagnosis:

MorphologicallyidenticaltoE.cuniculi,differentiationpossiblebasedon

immunologyandmolecularbiology.

Microspora 541

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Kayser, Medical Microbiology © 2005 Thieme