[Microsporidium spp. infection in an immunocompromised child diagnosed by polymerase chain reaction].
Microsporidium spp. may lead to a variety of clinical pictures like sinusitis, keratoconjunctivitis, hepatitis, myositis, peritonitis, nephritis, encephalitis and pneumonia in case of immune deficiencies. In this report, a case of diarrhea due to Microsporidium spp. has been presented. A four years old male patient who was followed with the diagnosis of myotonic dystrophia, was admitted to the hospital with the complaints of respiratory distress and fever. Due to the history of recurrent infections, further investigations was carried out to clarify the immunological status of the patient, and the total IgA and IgM levels were found as 14 mg/dl and 30 mg/dl, respectively (normal values were; 18-160 and 45-200 mg/dl, respectively). Following bronchoscopy done to enlighten respiratory distress, the patient developed high fever and watery diarrhea. Since bacteriological cultures of the stool yielded Shigella spp., antimicrobial therapy with ciprofloxacin was initiated. Parasitological examination of the stool done by Weber's modified trichrome dye, yielded Microsporidium spp. microscopically and albendazole was added to the treatment. Presence of Microsporidium spp. was confirmed by polymerase chain reaction with the use of C1 and C2 primers (Metabion, Germany) targeted to Microsporidium spp. and besides a 270 bp band specific for Encephalitozoon intestinalis was also obtained. This case emphasized that in case of diarrhea the stool samples of the immunocompromised patients should be evaluated in terms of Microsporidium spp. in addition to the routine parasitologic examinations.
Dokuz Eylül Üniversitesi Tıp Fakültesi, Parazitoloji Anabilim Dalı, İzmir, Türkiye. selmausluca@yahoo.com
Selma
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Usluca
Umit
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Aksoy
D015766:Albendazole / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000627:therapeutic use; D003967:Diarrhea / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004359:Drug Therapy, Combination; D005243:Feces / Q000382:microbiology*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D021861:Microsporidia, Unclassified / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D016881:Microsporidiosis / Q000175:diagnosis* / Q000188:drug therapy; D009223:Myotonic Dystrophy / Q000150:complications / Q000276:immunology; D012760:Shigella / Q000302:isolation & purification
D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D015766:Albendazole