Chronic diarrhea as a result of intestinal microsposidiosis in a liver transplant recipient

Background, Microsporidia are common pathogens among patients infected with human immunodeficiency virus. They account for a substantial proportion of chronic diarrhea and malabsorption in acquired immune deficiency syndrome, but their appearance after solid organ transplantation has only rarely bee n reported. Methods. We report what we believe is the first case of documented Enterocy tozoon bieneusi infection in a liver transplant recipient. Results. Our patient presented with chronic diarrhea and colicky abdominal pain. Although symptoms were severe, only mild microscopical mucosal change s were found in the intestinal tract, A modified trichrome stain of stool s pecimens revealed microsporidial spores, and species differentiation by res triction fragment length polymorphism polymerase chain reaction identified Enterocytozoon bieneusi. Albendazole therapy brought symptomatic relief but no microbiological clearance, Conclusions. Enterocytozoon bieneusi may cause chronic diarrhea not only in immunosuppression as a result of human immunodeficiency virus infection bu t also among patients with therapeutic immunosuppression after organ transp lantation. Therefore, microsporidial infection should be considered in immu nosuppressed patients with otherwise unexplained diarrhea.