Drug treatment of microsporidiosis

Microsporidia are ubiquitous organisms that are emerging pathogens in human s. These are most likely zoonotic and/or waterborne infections. In the immu nosuppressed host, such as those treated with immunosuppressive drugs or in fected with human immunodeficiency virus particularly at advanced stages of the disease, microsporidia can produce a wide range of clinical diseases. The most common manifestation is gastrointestinal tract infection; however, encephalitis, ocular infection, sinusitis, myositis and disseminated infec tion have also been described. In addition, these organisms have been repor ted in immune competent individuals. Multiple genes are involved in these i nfections and different organisms can result in distinct clinical pictures. Differences in clinical and parasitologic response to various therapeutic agents have emerged from clinical, as well as in vitro and in vivo studies. Currently there are no precisely defined guidelines for the optimal treatm ent of microsporidial infections. This article reviews the available data o n compounds with in vitro activity and/or in vivo efficacy for microsporidi al infections. (C) 2000 Harcourt Publishers Ltd.