Disseminated encephalitozoon cuniculi infection in a Mexican kidney transplant recipient.
BACKGROUND
No cases of Encephalitozoon cuniculi infection have been reported in transplant patients.


METHODS
A 42-year-old man received a renal transplant 8 months earlier because of terminal glomerulonephritis and was admitted with cough, fever, diarrhea, abdominal pain, and colon wall thickening. While under rapamycin (2 g/day), cyclosporine A (4.4 mg/kg/day), and prednisone (100 mg/day) therapy, he developed Banff grade IB graft rejection and was treated with methylprednisolone (1 g/day) for 3 days and oral prednisone (60 mg/d).


RESULTS
Microbiologic studies were inconclusive, and biopsy specimens of ileum, colon, liver, and the grafted kidney revealed numerous gram-positive microsporidia spores. Parasitophorous vacuoles containing various developing stages of Encephalitozoon were seen. Immunofluorescence studies identified the etiologic agent as E. cuniculi. Albendazole therapy resulted in clinical improvement but no eradication after 10 months of follow-up.


CONCLUSIONS
This report describes what is, to the authors' knowledge, the first case of disseminated E. cuniculi infection in a kidney transplant human immunodeficiency virus-negative patient from Mexico.
Gamboa-Dominguez
Armando
A
Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico. agd5@prodigy.net.mx
De Anda
Jazmin
J
Donis
Jose
J
Ruiz-Maza
Francisco
F
Visvesvara
Giovinda S
GS
Diliz
Hector
H
D000328:Adult; D000818:Animals; D003906:Developing Countries; D009670:Encephalitozoon cuniculi; D016890:Encephalitozoonosis / Q000175:diagnosis* / Q000517:prevention & control; D005921:Glomerulonephritis / Q000601:surgery; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D008297:Male; D008800:Mexico