INTESTINAL MICROSPORIDIOSIS - REPORT OF 5 CASES

Five cases of intestinal microsporidiosis are reported, including one case of a heterosexual female acquired immunodeficiency syndrome (AIDS ) patient, three homosexual males, and one bisexual male AIDS patients with detailed description of their clinical course. These five cases underscore the severity of immunodeficiency in patients with microspor idiosis. All patients had multiple opportunistic infections and a CD4 cell count below 100/mu l long before diarrhea developed. This is the first kinetic study of helper T-lymphocytes in cases of microsporidios is. Diagnosis was made by duodenal biopsies stained with Brown and Bre nn or Gram-Weigert technique (confirmed by electron microscopy) and by stool smears stained with a modified trichrome technique. However, th e best preparation was plastic sections stained with toluidine blue, w hich demonstrated both the spores and plasmodia clearly. In our evalua tion, Giemsa stain was also acceptable for identification of microspor idian spores in both intestinal biopsies and stool smears, but there w as a failure to identify the organism on hematoxylin and eosin, acid-f ast, periodic acid-Schiff, and Gomeri's methenamine silver stained pre parations. Therapeutic attempts using albendazole, metronidazole, octr eotide, and zidovudine (AZT) failed to eradicate microsporidia in thes e patients.