A patient with acquired immunodeficiency syndrome and untreated Encephalitozoon (Septata) intestinalis microsporidiosis leading to small bowel perforation. Response to albendazole
Soule, J.B.; Halverson, A.L.; Becker, R.B.; Pistole, M.C.; Orenstein, J.M.
Archives of Pathology and Laboratory Medicine 121(8): 880-887
1997
ISSN/ISBN: 0003-9985 PMID: 9278619 Document Number: 475196
A patient with acquired immunodeficiency syndrome and chronic diarrhoea presented to George Washington University Hospital in January 1996. Despite appropriate surgical specimens, no aetiology had been found to explain his cholecystitis, cystitis and enteritis 3 months previously at another hospital. Tissue specimens were analysed by light microscopy, using haematoxylin-eosin and the Armed Forces Institute of Pathology Brown-Brenn microsporidia stain, and by transmission electron microscopy. Urine and stool specimens were analysed by modified chromotrope 2R trichrome and chitin fluorochrome stains and by transmission electron microscopy. Disseminated Encephalitozoon intestinalis was diagnosed from duodenal biopsy, urine and stool specimens. On the 14th day of oral albendazole therapy, a partial small bowel resection was performed to correct a perforation (air under the diaphragm). There was no enterocytic microsporidian infection at that time, only spores undergoing macrophage digestion. Review of previous specimens showed severe E. intestinalis cholecystitis, cystitis and enteritis. Albendazole was restarted and after 2 weeks the patient had negative stool and urine specimens..