Microsporidia infection in transplant patients.
BACKGROUND
Microsporidia are the most common cause of chronic diarrhea in patients infected with human immunodeficiency virus. Patients who have undergone organ transplantation may also be infected. The precise immune defect and the clinical picture in transplant patients have not been studied.


METHODS
We report a case of microsporidia infection in a heart transplant patient and review three other cases reported in the literature.


RESULTS
Infection in three solid organ transplant patients occurred when the patients were receiving immunosuppressive therapy for rejection 1.5-3 years after transplantation. Patients had chronic diarrhea, vomiting, dyspepsia, and weight loss for 1 month to 3 years.


CONCLUSIONS
Microsporidia may be the cause of chronic unexplained diarrhea and gastrointestinal disturbances in transplant patients. Defects in cell-mediated immunity probably play a role in maintaining the chronicity of this infection. Specific screening requests should be made to the microbiology laboratory when microsporidia infection is suspected.
Department of Infectious Diseases, Cleveland Clinic Foundation, Ohio 44195, USA.
T
T
Gumbo
R E
RE
Hobbs
C
C
Carlyn
G
G
Hall
C M
CM
Isada
D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D003967:Diarrhea / Q000209:etiology / Q000469:parasitology; D005243:Feces / Q000469:parasitology; D006084:Graft Rejection / Q000188:drug therapy; D016027:Heart Transplantation / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016239:MEDLINE; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D016816:Microsporida / Q000302:isolation & purification; D016881:Microsporidiosis / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D011183:Postoperative Complications
D000890:Anti-Infective Agents; D007166:Immunosuppressive Agents; D008795:Metronidazole; D016572:Cyclosporine