Document 0326
 DOCN  M94A0326
 TI    Clinical features of microsporidiosis in patients with AIDS.
 DT    9412
 AU    Asmuth DM; DeGirolami PC; Federman M; Ezratty CR; Pleskow DK; Desai G;
       Wanke CA; Department of Pathology, New England Deaconess Hospital,
       Boston,; Massachusetts 02215.
 SO    Clin Infect Dis. 1994 May;18(5):819-25. Unique Identifier : AIDSLINE
       MED/94355523
 AB    Microsporidia are protozoan parasites responsible for significant
       gastrointestinal disease in patients infected with human
       immunodeficiency virus. We report the clinical features of 20 patients
       with chronic diarrhea for whom microsporidian spores were identified by
       modified trichrome staining of stool smears and confirmed by biopsy
       and/or electron microscopy of stool. Of the 18 microsporidian protozoa
       identified to the species level, 14 (78%) were Enterocytozoon bieneusi
       and four (22%) were Septata intestinalis. The mean CD4 count in these
       patients was 35 +/- 29 cells/mm3. Parameters of absorption, specifically
       absorption of fat and D-xylose, and levels of zinc were strikingly
       abnormal in patients who were tested. Treatment with albendazole led to
       clinical responses in six of 10 patients, and dietary manipulation
       resulted in clinical improvement in eight of nine patients. We
       recommended that patients with chronic, intermittent diarrhea and CD4
       counts of < 100 cells/mm3 be further evaluated for microsporidia by
       modified trichrome staining of stool and light and electron microscopy
       of small bowel biopsy specimens. Antiprotozoal therapies are currently
       experimental, but some patients who have been treated with these
       therapies have dramatic responses. We also recommend that special
       attention be paid to the measurement of parameters of absorption with
       appropriate modification of diet.
 DE    Adult  Albendazole/THERAPEUTIC USE  Animal  AIDS-Related Opportunistic
       Infections/DRUG THERAPY/EPIDEMIOLOGY/  *PARASITOLOGY
       Boston/EPIDEMIOLOGY  Chronic Disease  Diarrhea/DIET THERAPY/DRUG
       THERAPY/PARASITOLOGY  Human  *Intestinal Diseases, Parasitic/DRUG
       THERAPY/EPIDEMIOLOGY/  PARASITOLOGY  Leukocyte Count  Malabsorption
       Syndromes/DIET THERAPY/ETIOLOGY  Male  Metronidazole/THERAPEUTIC USE
       *Microspora Infections/COMPLICATIONS/DRUG THERAPY/EPIDEMIOLOGY
       Microsporida/*ISOLATION & PURIF  Retrospective Studies  T4 Lymphocytes
       JOURNAL ARTICLE  REVIEW  REVIEW, MULTICASE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).