title: Microsporidiosis in travel-associated chronic diarrhea in immune-competent patients.
abstract: We analyzed retrospectively 21 immune-competent travelers with chronic traveler's diarrhea (3-6 weeks) after returning from recreational travel to the tropics with stool samples positive for microsporidia. Nine patients had been treated with albendazole and 12 patients had been treated symptomatically. Diarrhea resolved in 8 of 9 and 12 of 12 patients, respectively. In the albendazole group, Encephalitozoon intestinalis was cleared in 4 of 4 patients and Enterocytozoon bieneusi persisted in 7 of 7 patients (2 patients were lost to follow-up). In the symptomatic treated group microsporidia persisted in stool samples of all patients. We conclude that there is only a transient correlation between detection of microsporidia in stool and gastrointestinal symptoms, and suggest that microsporidia infection may cause clinical symptoms during the early stages of infection that resolve even though the microsporidia may persist.
authors.affiliation: Department of Internal Medicine, University Hospital Graz, Medical University, Graz, Austria.
authors.forename: Erika
authors.initials: E
authors.lastname: Wichro
authors.forename: David
authors.initials: D
authors.lastname: Hoelzl
authors.forename: Robert
authors.initials: R
authors.lastname: Krause
authors.forename: Georg
authors.initials: G
authors.lastname: Bertha
authors.forename: Franz
authors.initials: F
authors.lastname: Reinthaler
authors.forename: Christoph
authors.initials: C
authors.lastname: Wenisch
mesh_terms: D000293:Adolescent; D000328:Adult; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003967:Diarrhea / Q000469:parasitology* / Q000503:physiopathology; D016819:Encephalitozoon / Q000302:isolation & purification*; D016890:Encephalitozoonosis / Q000469:parasitology / Q000503:physiopathology; D021862:Enterocytozoon / Q000302:isolation & purification*; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D007121:Immunocompetence; D007411:Intestinal Diseases, Parasitic / Q000469:parasitology* / Q000503:physiopathology; D008297:Male; D016881:Microsporidiosis / Q000469:parasitology* / Q000503:physiopathology; D008875:Middle Aged; D012189:Retrospective Studies; D014195:Travel
chemical_list: D000981:Antiprotozoal Agents; D015766:Albendazole