infectious diseases
Microsporidiosis
Key Points
Microsporidiosis occurs mainly in immunocompromised patients, predominantly those with AIDS, but keratoconjunctivitis is being increasingly reported in otherwise healthy people. Microsporidia spores can be acquired by ingestion, inhalation, direct contact with the conjunctiva, animal contact, or person-to-person transmission. Manifestations vary widely depending on the organism and the patient's immune status, but chronic diarrhea, malabsorption, wasting, cholangitis, punctate keratoconjunctivitis, peritonitis, hepatitis, myositis, or sinusitis may occur. Diagnose using light or electron microscopy with special stains; immunofluorescence assays and PCR-based assays are available in specialized laboratories. For patients with AIDS, initiation or optimization of ART is of primary importance. Albendazoleand oral or topical fumagillin may be useful, depending on the infecting species and organs involved; oral fumagillin is not available in the US. 