Enterocytozoon bieneusi in AIDS: symptomatic relief and parasite changes after furazolidone.

Dionisio, Daniele; Manneschi, Lidia Ibba; Lollo, Simonetta Di; Orsi, A; Sterrantino, Gaetana; Meli, Massimo; Gabbrielli, M; Tani, Akiyoshi; Papucci, A; Leoncini, F

doi:10.1136/jcp.50.6.472

Cited by 17 publications

(17 citation statements)

References 16 publications

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“…30 Clinical signs of diarrhea and wasting associated with E. bieneusi are reported to improve with albendazole, thalidomide, fumagillin, or furazolidone therapy, but elimination of infection has not been confirmed with these compounds. 45,47,90,125 In a more recent study, clindamycin was suggested to be efficacious against E. bieneusi infection. 72 Encephalitozoon intestinalis (originally named Septata intestinalis) was differentiated from Enterocytozoon bieneusi in 1993 as yet another agent of chronic diarrhea and weight loss in AIDS patients.…”

Section: Microsporidiosis As An Emerging Human Diseasementioning

confidence: 99%

Mammalian Microsporidiosis

2000

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Abstract. The phylum Microspora contains a diverse group of single-celled, obligate intracellular protozoa sharing a unique organelle, the polar filament, and parasitizing a wide variety of invertebrate and vertebrate animals, including insects, fish, birds, and mammals. Encephalitozoon cuniculi is the classic microsporidial parasite of mammals, and encephalitozoonosis in rabbits and rodents has been and continues to be recognized as a confounding variable in animal-based biomedical research. Although contemporary research colonies are screened for infection with this parasite, E. cuniculi remains a cause of morbidity and mortality in pet and conventionally raised rabbits. In addition, E. cuniculi is a potential pathogen of immature domestic dogs and farm-raised foxes. The recent discovery and identification of Encephalitozoon intestinalis, Encephalitozoon hellem, and Enterocytozoon bieneusi, in addition to E. cuniculi, as opportunistic pathogens of humans have renewed interest in the Microspora. Veterinary pathologists, trained in the comparative anatomy of multiple animal species and infectious disease processes, are in a unique position to contribute to the diagnosis and knowledge of the pathogenesis of these parasitic diseases. This review article covers the life cycle, ultrastructure, and biology of mammalian microsporaidia and the clinical disease and lesions seen in laboratory and domestic animals, particularly as they relate to Encephalitozoon species. Human microsporidial disease and animal models of human infection are also addressed. Often thought of as rabbit pathogens of historical importance, E. cuniculi and the related mammalian microsporidia are emerging as significant opportunistic pathogens of immunocompromised individuals.

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Section: Microsporidiosis As An Emerging Human Diseasementioning

confidence: 99%

Mammalian Microsporidiosis

2000

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“…The drug fumagillin has also demonstrated good anti-Enterocytozoon bieneusi activity (40,57,195), although various adverse side effects have been documented (56,141,194,195). The drug furazolidone has also demonstrated a degree of anti-Enterocytozoon activity (74). As with most opportunistic infections, HAART plays a key role in eradicating microsporidia in HIV-infected patients (105), and effective HAART is likely to reduce the incidence of microsporidial infections in the future.…”

Section: Microsporidiamentioning

confidence: 99%

Clinical Significance of Enteric Protozoa in the Immunosuppressed Human Population

et al. 2009

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SUMMARY Globally, the number of immunosuppressed people increases each year, with the human immunodeficiency virus (HIV) pandemic continuing to spread unabated in many parts of the world. Immunosuppression may also occur in malnourished persons, patients undergoing chemotherapy for malignancy, and those receiving immunosuppressive therapy. Components of the immune system can be functionally or genetically abnormal as a result of acquired (e.g., caused by HIV infection, lymphoma, or high-dose steroids or other immunosuppressive medications) or congenital illnesses, with more than 120 congenital immunodeficiencies described to date that either affect humoral immunity or compromise T-cell function. All individuals affected by immunosuppression are at risk of infection by opportunistic parasites (such as the microsporidia) as well as those more commonly associated with gastrointestinal disease (such as Giardia). The outcome of infection by enteric protozoan parasites is dependent on absolute CD4+ cell counts, with lower counts being associated with more severe disease, more atypical disease, and a greater risk of disseminated disease. This review summarizes our current state of knowledge on the significance of enteric parasitic protozoa as a cause of disease in immunosuppressed persons and also provides guidance on recent advances in diagnosis and therapy for the control of these important parasites.

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“…However, significant thrombocytopenia and neutropenia occurred in three out of the six patients in the treatment arm. Furazolidone, on the other hand, was found to provide symptomatic relief and decreased parasite shedding but not eradication in the stools of six patients with AIDS and E. bieneusi [129]. A further study by the same group using the combination of this drug with albendazole again failed to demonstrate eradication of the parasite [130].…”

Section: Microsporidiosismentioning

confidence: 92%

Management of protozoa-related diarrhea in HIV infection

Lean

Pollok²

2003

Expert Review of Anti-infective Therapy

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Protozoa infections are an important cause of chronic diarrhea in patients infected with HIV. The introduction of highly active antiretroviral treatment to the management of HIV in the mid 1990s has led to a dramatic reduction in the incidence of these opportunistic infections in Europe and America. In contrast, in the developing world where such treatments are not readily affordable, protozoa-related diarrhea remains a major cause of morbidity and mortality in HIV-infected individuals. In this review, the optimum investigations required to diagnose these pathogens in HIV-related diarrhea, as well as current treatment options, will be discussed.

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Enterocytozoon bieneusi in AIDS: symptomatic relief and parasite changes after furazolidone.

Cited by 17 publications

References 16 publications

Mammalian Microsporidiosis

Mammalian Microsporidiosis

Clinical Significance of Enteric Protozoa in the Immunosuppressed Human Population

Management of protozoa-related diarrhea in HIV infection

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