PULMONARY MICROSPORIDIOSIS DUE TO ENCEPHALITOZOON HELLEM IN A PATIENTWITH AIDS

The microsporidian Encephalitozoon hellem is being reported with incre asing frequency in HIV-positive subjects, as an agent of disseminated microsporidiosis without involving the gastrointestinal tract. We desc ribe a case of pulmonary microsporidiosis in a 27-year-old Italian man with AIDS who developed fever, cough, and dyspnea. A chest X-ray show ed multiple bilateral pulmonary opacities and mediastinal lymph-node e nlargement. Stained smears of bronchoalveolar lavage sediment showed o val structures consistent with microsporidian spores. Viral, bacterial and fungal cultures were repeatedly negative, whereas microsporidia w ere successfully cultured in human and bovine fibroblast cell lines. A nalysis of electron micrographs indicated that the isolate belonged to the genus Encephalitozoon. Based on further immunological, biochemica l and molecular studies it was characterized as E. hellem. Even though a temporary improvement with albendazole therapy was noticed the pati ent deteriorated clinically and died of severe respiratory distress.