DISSEMINATED MICROSPORIDIOSIS DUE TO ENCEPHALITOZOON-HELLEM - PULMONARY COLONIZATION, MICROHEMATURIA, AND MILD CONJUNCTIVITIS IN A PATIENT WITH AIDS

Four genera of microsporidia have been associated with disease in huma ns, which predominantly affects immunocompromised persons. Systemic in fection with a newly characterized microsporidian species, Encephalito zoon hellem, was recently reported in a patient with AIDS. This articl e describes a second patient with AIDS and disseminated E. hellem infe ction. In this case the parasite was detected in sputum, urine, and co njunctival swab specimens. Apart from recurrent mild conjunctivitis an d asymptomatic microhematuria, the patient had no findings or symptoms that could be related to this parasite. Specifically, no microsporidi an-associated pulmonary pathology was documented. Detection of E. hell em in the patient's sputum may have epidemiological implications in th at this finding suggests transmission of microsporidia by the aerosol route. Because the patient died of unrelated complications, it remains unknown whether he was an asymptomatic carrier of microsporidia or wh ether microhematuria heralded early microsporidian disease, with the o nset of cellular damage in the urinary tract.