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.
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.
Authors: Hana Talabani; Claudine Sarfati; Evangeline Pillebout; Tom van Gool; Francis Derouin; Jean Menotti Journal: J Clin Microbiol Date: 2010-05-12 Impact factor: 5.948
Authors: A L Galván; A M Martín Sánchez; M A Pérez Valentín; N Henriques-Gil; F Izquierdo; S Fenoy; C del Aguila Journal: J Clin Microbiol Date: 2011-02-16 Impact factor: 5.948
Authors: Daan W Notermans; Ron Peek; Menno D de Jong; Ellen M Wentink-Bonnema; René Boom; Tom van Gool Journal: J Clin Microbiol Date: 2005-02 Impact factor: 5.948