Self-limited traveller's diarrhea due to a dual infection withEnterocytozoon bieneusi andCryptosporidium parvum in an immunocompetent HIV-negative child

Sobottka, Ingo; Albrecht, Helmut; Schottelius, Justus Georg; Schmetz, Christel; Bentfeld, M.; Laufs, Rainer; Schwartz, David A.

doi:10.1007/bf01691502

Cited by 65 publications

(34 citation statements)

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“…Most cases of human microsporidiosis are associated with immunosuppression, but increasing numbers of cases in non-HIV-infected immunocompetent patients are reported. These reports include infections of travelers to developing countries as well as infections of residents of various tropical countries (1,5,6,11,13,14,17,(19)(20)(21)23). Only a few studies examined the role of microsporidia in returning travelers.…”

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confidence: 99%

Detection of Microsporidia in Travelers with Diarrhea

et al. 2001

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We examined stool specimens of 148 returning travelers from an outpatient department for tropical diseases for the appearence of microsporidia using light microscopy and PCR. Intestinal microsporidiosis was diagnosed for five patients by light microscopy and for nine patients by PCR. Some cases were diagnosed only by PCR, indicating that the true prevalence has to be determined by highly sensitive techniques, such as PCR.Diarrhea affects 20 to 70% of travelers in tropical or subtropical countries. Typically, self-limiting travelers' diarrhea is more of an inconvenience than a life-threatening disease. In general, bacteria, e.g., Escherichia coli, are the most common pathogens isolated in travelers' diarrhea. However, different intestinal protozoan parasites are recognized in travelers with diarrhea as well. Microsporidia are important protozoan parasites in human immunodeficiency virus (HIV)-infected patients. Limited data are available about microsporidian infections in immunocompetent patients and travelers (1,17,19,21).Stool samples were obtained from 148 travelers with diarrhea returning from different tropical areas between January and March 1998. Stool samples were examined by light microscopy (Uvitex 2B staining) and PCR as previously described (16). PCR products were digested with the restriction endonucleases PstI (20 U) and HaeIII (10 U) (Sigma) in a final volume of 15 l, producing distinctive fragments. The 250-bp DNA fragment of Enterocytozoon bieneusi was not cut by PstI and produced a 208-bp DNA fragment after digestion with HaeIII. The 268-bp DNA fragment of Encephalitozoon cuniculi was cut by PstI into two, 122-and 146-bp DNA fragments and by HaeIII into a 189-bp DNA fragment. The 270-bp DNA fragment of Encephalitozoon intestinalis was cut by PstI into two, 124-and 146-bp DNA fragments and by HaeIII into a 193-bp DNA fragment. The 279-bp DNA fragment of Encephalitozoon hellem was cut by PstI into two, 133-and 146-bp DNA fragments and by HaeIII into a 200-bp DNA fragment (9). Purified DNA fragments were ligated into a pGEM-T vector (Promega). Plasmids were transfected in competent E. coli cells (JM109) and plated on ampicillin-isopropyl-␤-D-thiogalactopyranoside-S-bromo-4-chloro-3-indolyl-␤-D-galactopyranoside agar plates for blue-white screening. White colonies were selected, and plasmids were isolated from the cells by using the High Pure plasmid isolation kit (Boehringer, Mannheim, Germany). Both DNA strands of the cloned DNA fragments were sequenced on an automated DNA sequencer (ABI Prism 377 DNA Sequencer; Applied Biosystems) using the Taq FS BigDye-terminator cycle sequencing method starting with two vector-directed primers (T7 primer [5Ј-TAATACGACTC ACTATAGGG-3Ј] and M-13 reverse primer [5Ј-TTCACACA GGAAACAGCTATGACG-3Ј]) flanking the cloned DNA fragments.

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Detection of Microsporidia in Travelers with Diarrhea

et al. 2001

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“…bieneusi infec tion in an immunocompetent adult has been reported by Sandfort et al6; this was an HIV-seronegative adult with acute, self-limited traveller's diarrhea, whose CD4+ cell count and plasma immunoglobulin values were normal. A case of self-limited traveller's diarrhea in an immunocompetent HIVseronegative child with intestinal infection with E. bieneusi and Cryptosporidium parvum was recently presented by Sobottka et al 7 We report a case of asymptomatic intestinal E, bieneusi infection in a HIV-seronegative, immunocompe tent Zambian child.…”

Section: Asymptomatic Intestinal Microsporidiosis In a Human Immunodementioning

confidence: 75%

Asymptomatic Intestinal Microsporidiosis in a Human Immunodeficiency Virus-Seronegative, Immunocompetent Zambian Child

Hautvast

Tolboom²,

Derks³

et al. 1997

The Pediatric Infectious Disease Journal

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“…1995), whereas prevalence of microsporidiosis was estimated at 23 % among AIDS patients with chronic diarrhea in Zambia (Drobniewski, 1995). In another large study conducted in Niger, E. bieneusi spores were recovered from stools of 8/990 children who were not consi dered HIV positive, thereby suggesting a high pre valence of enteric carriage among immunocompetent persons in tropical countries (Bretagne, 1993), In addition, microsporidiosis has also been recognized as a cause of traveler's diarrhea in immunocompetent individuals returning from the Middle-East (Sandfort, 1994;Sobottka, 1995). Thus, our results are in agree ment with the hypothesis of a high rate of transmis sion of microsporidiosis in tropical and sub-tropical areas.…”

Section: Resultsmentioning

confidence: 99%