DISSEMINATED MICROSPORIDIOSIS DUE TO SEPTATA-INTESTINALIS IN PATIENTSWITH AIDS - CLINICAL-FEATURES AND RESPONSE TO ALBENDAZOLE THERAPY

Five patients with AIDS had disseminated infection due to Septata inte stinalis, a recently described organism. S. intestinalis infection was suspected after detection of spores in stools and urine and confirmed by transmission electron microscopy of duodenal biopsies or of cell c ulture of urine sediment. Clinical features included chronic diarrhea that was usually associated with fever, cholangitis, sinusitis, bronch itis, or mild bilateral conjunctivitis. Mean CD4 cell count was 22/mu L. Patients treated with albendazole (400 mg orally twice a day) for a mean of 19 days had a dramatic and rapid clinical response to therapy . Significant reduction of parasite shedding was also observed during therapy; S. intestinalis was cleared from stools of all patients and f rom urine of 3. In 2 patients, however, microsporidian spores were det ected in feces during follow-up and mild diarrhea recurred. Therefore, albendazole seems to have a significant but transient effect in treat ment of S. intestinalis infection.