title: The diagnostic value of electron microscopy in human immunodeficiency virus-positive patients with gastrointestinal disease.
abstract: BACKGROUND
  Our aim was to determine the diagnostic value of electron microscopy in evaluating the etiology of gastrointestinal disease in patients infected with the human immunodeficiency virus (HIV).
  
  
  METHODS
  A retrospective review of electron microscopic and light microscopic results of all HIV-positive patients with gastrointestinal and liver diseases was made during a 3-year period from June 1995 to June 1998.
  
  
  RESULTS
  A total of 145 HIV-positive patients had their electron microscopy specimens reviewed. Of these, 136 were investigated for diarrhea, and the other 9 for increased liver enzymes. Twenty-seven of the 145 (18.6%) HIV-positive patients had a pathogen identified by electron microscopy, compared with only 13 of 145 (9%) identified by light microscopy (P < 0.005). The sensitivity of light microscopy for detecting opportunistic pathogens was 68%. Twenty-one of the 27 (77.8%) patients diagnosed by electron microscopy had microsporidiosis, and the most commonly diagnosed species was Enterocytozoon bieneusi. Light microscopy failed to identify 12 cases of microsporidiosis and 2 cases of leishmaniasis.
  
  
  CONCLUSIONS
  Electron microscopy contributes substantially to the identification of pathogens in HIV-positive patients. Light microscopy failed to identify one of every two pathogens diagnosed by electron microscopy.
authors.affiliation: Dept. of Gastroenterology and Pathology, St. Vincent's Hospital, New York, New York 10011, USA.
authors.forename: O
authors.initials: O
authors.lastname: Olofinlade
authors.forename: O
authors.initials: O
authors.lastname: Adeonigbagbe
authors.forename: M
authors.initials: M
authors.lastname: Karowe
authors.forename: J
authors.initials: J
authors.lastname: Robilotti
authors.forename: N
authors.initials: N
authors.lastname: Gualtieri
authors.forename: A
authors.initials: A
authors.lastname: Cacciarelli
authors.forename: I
authors.initials: I
authors.lastname: Berlin
authors.forename: C
authors.initials: C
authors.lastname: Guerrieri
mesh_terms: D000328:Adult; D005260:Female; D019053:HIV Enteropathy / Q000209:etiology* / Q000469:parasitology; D006801:Humans; D008109:Liver Diseases, Parasitic / Q000175:diagnosis; D008297:Male; D008854:Microscopy, Electron; D012189:Retrospective Studies; D012680:Sensitivity and Specificity