MULTIORGAN MICROSPORIDIOSIS - REPORT OF 5 CASES AND REVIEW

We describe five cases and review 34 reported cases of multiorgan micr osporidiosis. Most of the patients with multiorgan involvement have be en adults with AIDS. Organs most commonly infected include the small i ntestine, urinary tract, biliary tree, and eye; involvement of the res piratory tract, nasal sinuses, and central nervous system is also desc ribed but appears to be less frequent. Although patients with multiorg an disease may be asymptomatic, clinical presentation usually relates to the involved organs. Enterocytozoon bieneusi and Septata intestinal is are the most frequently identified species of pathogens. An affinit y for certain tissues is observed among different microsporidial speci es. In all but one case of E. bieneusi infection, infection was limite d to intestinal and hepatobiliary tracts, a finding suggestive of loca l extension. In contrast, the patients infected with S. intestinalis h ad widespread involvement, suggesting true hematogenous or lymphatic d issemination. Treatment may have to be based on findings regarding whi ch organs and specific microsporidial species are involved. Further in vestigation of the pathogenic tendencies and route of acquisition of t hese organisms and the therapeutic agents active against them is neede d.