Intracellular Protozoan Infection in Small Intestinal Biopsies of Patients with AIDS

Boldorini, Renzo; Tosoni, Antonella; Mazzucco, Gianna; Cernuschi, Massimo; Caramello, Pietro; Maran, E; Costanzi, G; Monga, Guido

doi:10.1016/s0344-0338(96)80228-7

Cited by 7 publications

(4 citation statements)

References 31 publications

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“…Other authors have also described the villus atrophy and crypt hyperplasia as a frequent finding [11,58,74,77,82]. However, some microsporidosis reported cases presented without villous atrophy [10]. The increased intraepithelial lymphocytic infiltrates were found in some patients (4/14 cases), similar as described by other authors [58,74,79,82].…”

Section: Discussionsupporting

confidence: 80%

“…Duodenal biopsy samples stained with Giemsa, H&E and Azure II helped to identify microsporidia-compatible structures by light microscopy in more than 12% of cases. In Italy, in a study including 21 patients with AIDS and chronic diarrhoea in duodenal biopsies stained with H&E and toluidine blue microsporidia were identified with security in two cases (9.52%) and were suspected in 3 cases [10]. In another study of 59 patients with AIDS and chronic diarrhoea in duodenal biopsies stained with H&E and Giemsa, diagnosis of microsporidia was performed in 8 patients reaching 13% [79].…”

Section: Discussionmentioning

confidence: 99%

“…The variable sensitivity of the light microscopy in different reports could be given by the focal distribution of infected enterocytes and selected sites for biopsies that may or may not correspond to infected cells [13,65]. Another possibility is the difficulty in identifying structures compatible with microsporidia in cases with low parasite burden [10,65]. Numerous studies agree that the identification of intracellular stages compatible with microsporidia depends on careful observation and interpretation of histopathology [4,46,64].…”

Section: Discussionmentioning

confidence: 99%

“…Some authors suggest re-observation of histological slides if microsporidian suggestive microorganisms are present [4]. This difficulty in identifying compatible parasitic structures with microsporidia using H&E and Giemsa was mentioned by different authors [4,10,13,46,65,76]. One reason is that while the spores are easier to identify, it is not so with other parasitic stages given the minimal contrast between the parasitic structure and the cytoplasm of the infected cell [46,65].…”

Section: Discussionmentioning

confidence: 99%

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Multimethodological Approach to Gastrointestinal Microsporidiosis in HIV-Infected Patients

et al. 2019

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Purpose Microsporidiosis is an opportunistic infection that produces chronic diarrhoea and cholangiopathy in patients with AIDS, mainly caused by two species of microsporidia, Enterocytozoon bieneusi and Encephalitozon intestinalis. The aim of this work was to develop an integral system for the diagnosis of microsporidiosis of the intestine and biliary tract in HIVinfected patients, comprising microscopic and molecular techniques. Methods The study population comprised 143 adult patients of both sexes with diagnosis of HIV infection, with chronic diarrhoea, and with or without HIV-associated cholangiopathy. Stool studies for microsporidia identification of spores were performed on each patient. A video esofagogastroduodenoscopy with biopsy collection was also carried out for routine histology and semi-thin sections stained with Azure II. Species identification was carried out by transmission electron microscopy and/or polymerase chain reaction for the species E. bieneusi and E. intestinalis. Results Out of the 143 patients a total of 12.6% (n = 18) were infected with microsporidia. Microsporidia species identified in most cases was E. bieneusi (16/18 cases), followed by E. intestinalis (4/18), all of these last ones in coinfection with E. bieneusi. Conclusions Clinical, imaging, microscopic and molecular analyses, when applied in a systematic and integrated approach, allow diagnosis and identification of microsporidia at species level in AIDS patients with chronic diarrhoea, and with or without HIV-associated cholangiopathy.

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