title: Disseminated microsporidiosis in a renal transplant recipient.
abstract: Disseminated microsporidiosis is diagnosed uncommonly in patients not infected with human immunodeficiency virus (HIV). We present a case of disseminated microsporidiosis in a renal transplant recipient who was seronegative for HIV. Chromotrope-based stains were positive for microsporidia in urine, stools, sputum, and conjunctival scrapings. Electron microscopy, immunofluorescence, polymerase chain reaction, and cultures of renal tissue identified the organism as Encephalitozoon cuniculi. The patient was treated with oral albendazole and topical fumagillin with clinical improvement. In addition, she underwent a transplant nephrectomy and immunosuppressive therapy was withdrawn. Follow-up samples were negative for microsporidia. However, the patient developed central nervous system manifestations and died. An autopsy brain tissue specimen demonstrated E. cuniculi by immunofluorescent staining. Disseminated microsporidiosis must be considered in the differential diagnosis of multiorgan involvement in renal allograft recipients.
authors.affiliation: Department of Internal Medicine, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
authors.forename: A R
authors.initials: AR
authors.lastname: Mohindra
authors.forename: M W
authors.initials: MW
authors.lastname: Lee
authors.forename: G
authors.initials: G
authors.lastname: Visvesvara
authors.forename: H
authors.initials: H
authors.lastname: Moura
authors.forename: R
authors.initials: R
authors.lastname: Parasuraman
authors.forename: G J
authors.initials: GJ
authors.lastname: Leitch
authors.forename: L
authors.initials: L
authors.lastname: Xiao
authors.forename: J
authors.initials: J
authors.lastname: Yee
authors.forename: R
authors.initials: R
authors.lastname: del Busto
mesh_terms: D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002460:Cell Line; D009670:Encephalitozoon cuniculi / Q000302:isolation & purification / Q000648:ultrastructure; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D016881:Microsporidiosis / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D008875:Middle Aged
chemical_list: D000981:Antiprotozoal Agents