[Epidemiological and clinical characteristics of intestinal microsporidiosis].
BACKGROUND
Intestinal microsporidiosis is an opportunistic parasitological infection affecting mainly immunocompromised patients, particularly those infected with HIV.


OBJECTIVE
The purpose of this study was to analyse the epidemiological and clinical characteristics of intestinal microsporidiosis and the treatments available for it.


METHODS
This retrospective study examined records collected over a 13-year period (from January 1995 through December 2007). It included 572 immunocompromised patients (279 HIV-infected patients and 293 without HIV infection) with symptoms suggesting intestinal microsporidiosis. All were tested systematically for microsporidia spores by modified (Weber's) Trichrome staining.


RESULTS
Fourteen patients (10 men, 4 women) were diagnosed with intestinal microsporidiosis, for a prevalence of 2.4% overall, 3.6% in HIV-infected patients and 1.4% in those without HIV infection. Intestinal microsporidiosis affected 10 HIV-infected patients, 70% of whom had a CD4 count <100 cells/mm3. Their mean age was 30+/-15 years (range: 15 months to 48 years). The average age of HIV-infected patients (36 years) was significantly higher than of those without HIV infection (15 years). Thirteen patients had symptoms, most frequently diarrhea (11 cases), sometimes associated with dehydration (5 cases). Eight patients (57%) received only symptomatic treatment, and 4 (28.6%) received albendazole. No treatment was recommended in 2 cases (14.3%). Clinical course was marked by improvement in 6 cases, death in 5, and persistence of asymptomatic carriage in one. Two patients were lost to follow-up.


CONCLUSIONS
Intestinal microsporidiosis is a parasitological disease that mainly affects AIDS patients with CD4 counts <100 cells/mm3. Its diagnosis requires special techniques. Its symptomatology is dominated by chronic diarrhea that can cause dehydration. Effective treatment requires identification of the species.
Anane
Sonia
S
Laboratoire de parasitologie-mycologie CHU La Rabta 15, rue Djebel-Lakhdhar 1007 Tunis, Tunisie. anane.sonia@planet.tn
Attouchi
H
H
Kaouech
E
E
Belhadj
S
S
Ben Chaabane
T
T
Ben Abdallah
N
N
Ben Othman
T
T
Samoud
A
A
Ben Hriz
M
M
Kallel
K
K
Chaker
E
E
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D007410:Intestinal Diseases / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D016881:Microsporidiosis / Q000453:epidemiology*; D008864:Microsporum; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons; D014416:Tunisia / Q000453:epidemiology