Case series of intestinal microsporidiosis in non-HIV patients caused by Encephalitozoon hellem

Abstract

Intestinal microsporidiosis is most often caused by Enterocytozoon bieneusi , and to a lesser extent by species of the genus Encephalitozoon . Until now, Encephalitozoon hellem was not clearly known to induce disease restricted to the intestine, or rarely in HIV subjects or in tropical countries. We report here 11 cases of delineated intestinal microsporidioses due to E. hellem diagnosed in France in non-HIV patients. Briefly, all patients were immunocompromised. They all suffered from diarrhoea, associated in nearly 50% of cases with weight loss. Concerning treatment, 5/11 patients had a discontinuation or a decrease of their immunosuppressive therapy, and 4/11 received albendazole. All patients recovered. Five different genotypes were identified based on the rRNA ITS sequence.

Microsporidia persistence in host impairs epithelial barriers and increases chances of inflammatory bowel disease

“…The consequent intestinal damage and microbiota disturbance lead to increased host vulnerability to enteritis, as manifested by DSS-induced inflammatory bowel diseases. We utilized E. hellem and E. intestinalis , two commonly diagnosed digestive tract-infecting microsporidia species with comparable endemic rates, in our study to get a comprehensive view of the effects of microsporidia on epithelium barriers ( 29 , 30 ). Our findings may help to explain the recurrent diarrheal and other intestinal abnormalities after microsporidia infection on molecular basis.…”

Encephalitozoon hellem infection after haploidentical allogeneic hematopoietic stem cell transplantation in children: a case report

“…However, with the development of diagnostic techniques, microsporidia can be identified using traditional histopathological staining, transmission electron microscopy, staining microscopes, as well as immunological and molecular biological detection methods. Encephalitozoon hellem infection has been reported in patients with AIDS, solid organ transplant recipients, leukemia, lymphoma, hemodialysis, and malignant solid tumors (5)(6)(7)(8)(9). We reviewed several case reports of non-HIV patients infected with E. hellem (6,7,10), totaling 13 cases.…”

“…Encephalitozoon hellem infection has been reported in patients with AIDS, solid organ transplant recipients, leukemia, lymphoma, hemodialysis, and malignant solid tumors (5)(6)(7)(8)(9). We reviewed several case reports of non-HIV patients infected with E. hellem (6,7,10), totaling 13 cases. The most common clinical manifestation was diarrhea, followed by weight loss, nausea, and fever (Figure 1D).…”

“…In terms of E. hellem infection, Nourrisson ( 6 ) reported multiple cases of patients showing significant improvement after treatment with albendazole and a reduction in the original immunosuppressants, leading to a cure in almost all patients. In this case, the infected child also quickly recovered from fever and diarrhea symptoms after receiving albendazole treatment, and the symptoms of cystitis were alleviated as well.…”