title: Diagnosis of intestinal and disseminated microsporidial infections in patients with HIV by a new rapid fluorescence technique.
abstract: OBJECTIVE
  To assess the value of a new rapid fluorescence method for the diagnosis of microsporidiosis in HIV seropositive patients.
  
  
  METHODS
  Microsporidian spores in stools were demonstrated by using the fluorochrome stain Uvitex 2B. The new technique was evaluated in three groups of HIV seropositive patients with diarrhoea. Group 1: 19 patients with biopsy confirmed E bieneusi infection (186 stool samples); group 2: 143 consecutive patients from whom faeces were submitted for routine investigation of diarrhoea (318 samples); group 3: 16 patients with small intestinal biopsy specimens negative for microsporidia (55 samples). The new method was used to monitor spore shedding during experimental treatment with paromomycin and albendazole in four patients.
  
  
  RESULTS
  Brightly fluorescent spores were detected in all stool samples of patients in group 1. In group 2 16 (11%) patients had spores in their stool samples. E bieneusi was found in 11 patients; in the other five another genus of microsporidia, Encephalitozoon, was recognised. Encephalitozoon spores were also found in the urine of three of these patients and in the maxillary sinus aspirate of two of them, suggesting disseminated infection. The results were confirmed by electron microscopic examination. In group 3 negative biopsy specimens were confirmed by negative stool samples in all cases. Treatment with albendazole and paromomycin did not affect the spore shedding in three patients with E bieneusi infection. By contrast, in a patient with Encephalitozoon sp infection albendazole treatment resulted in clinical improvement together with complete cessation of spore excretion in the stool.
  
  
  CONCLUSIONS
  The Uvitex 2B fluorescence method combines speed, sensitivity, and specificity for the diagnosis and treatment evaluation of intestinal and disseminated microsporidiosis.
authors.affiliation: Department of Medical Microbiology, University of Amsterdam, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: van Gool
authors.forename: F
authors.initials: F
authors.lastname: Snijders
authors.forename: P
authors.initials: P
authors.lastname: Reiss
authors.forename: J K
authors.initials: JK
authors.lastname: Eeftinck Schattenkerk
authors.forename: M A
authors.initials: MA
authors.lastname: van den Bergh Weerman
authors.forename: J F
authors.initials: JF
authors.lastname: Bartelsman
authors.forename: J J
authors.initials: JJ
authors.lastname: Bruins
authors.forename: E U
authors.initials: EU
authors.lastname: Canning
authors.forename: J
authors.initials: J
authors.lastname: Dankert
mesh_terms: D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D016819:Encephalitozoon / Q000302:isolation & purification; D005243:Feces / Q000469:parasitology; D005455:Fluorescent Antibody Technique; D005456:Fluorescent Dyes; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis / Q000469:parasitology*; D016816:Microsporida / Q000302:isolation & purification*; D016881:Microsporidiosis / Q000175:diagnosis* / Q000188:drug therapy; D010303:Paromomycin / Q000627:therapeutic use
chemical_list: D005456:Fluorescent Dyes; D010303:Paromomycin; D015766:Albendazole