TY - JOUR
T1 - Disseminated microsporidiosis especially infecting the brain, heart, and kidneys
T2 - Report of a newly recognized pansporoblastic species in two symptomatic AIDS patients
AU - Yachnis, Anthony T.
AU - Berg, Johannes
AU - Martinez-Salazar, Ariel
AU - Bender, Bradley S.
AU - Diaz, Leslie
AU - Rojiani, Amyn M.
AU - Eskin, Thomas A.
AU - Orenstein, Jan M.
PY - 1996/10
Y1 - 1996/10
N2 - Microsporidia have emerged as important opportunistic AIDS pathogens of the alimentary, respiratory, and urinary tracts. Although nonhuman mammalian microsporidia infections typically include encephalitis, CNS microsporidiosis has not been reported in patients with AIDS. A 33-year-old white male and an 8-year-old black girl presented with seizures and declining mental status. Central nervous system (CNS) imaging studies revealed small peripherally and diffusely enhancing lesions present for at least 2 and 4 months before death, respectively. Both patients expired despite empirical anti-toxoplasma therapy. Their brains contained innumerable soft gray matter lesions that consisted of central areas of necrosis, filled with free spores and spore- laden macrophages, surrounded by microsporidia-infected astrocytes. The complete autopsy of the child also revealed necrotizingand sclerosing cardiac and renal microsporidiosis and infection of the pancreas, thyroid, parathyroids, liver, spleen, lymph nodes, and bone marrow. Infected cells included astrocytes, cardiac myocytes, epithelium, endothelium, vascular smooth muscle cells, hepatocytes, adipocytes, Schwann cells, and macrophages. Light and electron microscopic studies revealed pansporoblastic development within thick-walled sporophorous vacuoles of parasite origin. Although most similar to Pleistophora sp and Thelohania sp, this microsporidian is different from any known species. Microsporidiosis should be considered as the possible cause of a wide range of diseases in AIDS patients, including CNS, cardiac, and renal.
AB - Microsporidia have emerged as important opportunistic AIDS pathogens of the alimentary, respiratory, and urinary tracts. Although nonhuman mammalian microsporidia infections typically include encephalitis, CNS microsporidiosis has not been reported in patients with AIDS. A 33-year-old white male and an 8-year-old black girl presented with seizures and declining mental status. Central nervous system (CNS) imaging studies revealed small peripherally and diffusely enhancing lesions present for at least 2 and 4 months before death, respectively. Both patients expired despite empirical anti-toxoplasma therapy. Their brains contained innumerable soft gray matter lesions that consisted of central areas of necrosis, filled with free spores and spore- laden macrophages, surrounded by microsporidia-infected astrocytes. The complete autopsy of the child also revealed necrotizingand sclerosing cardiac and renal microsporidiosis and infection of the pancreas, thyroid, parathyroids, liver, spleen, lymph nodes, and bone marrow. Infected cells included astrocytes, cardiac myocytes, epithelium, endothelium, vascular smooth muscle cells, hepatocytes, adipocytes, Schwann cells, and macrophages. Light and electron microscopic studies revealed pansporoblastic development within thick-walled sporophorous vacuoles of parasite origin. Although most similar to Pleistophora sp and Thelohania sp, this microsporidian is different from any known species. Microsporidiosis should be considered as the possible cause of a wide range of diseases in AIDS patients, including CNS, cardiac, and renal.
KW - AIDS
KW - Central nervous system
KW - Disseminated
KW - Heart
KW - Kidneys
KW - Microsporidia
KW - Pancreas
KW - Pansporoblast ic
KW - Parathyroid
KW - Thyroid
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U2 - 10.1093/ajcp/106.4.535
DO - 10.1093/ajcp/106.4.535
M3 - Article
C2 - 8853044
AN - SCOPUS:0029780077
SN - 0002-9173
VL - 106
SP - 535
EP - 543
JO - American Journal of Clinical Pathology
JF - American Journal of Clinical Pathology
IS - 4
ER -