Emerging Microsporidiosis in HIV+/AIDS Patient

1
Luluk Mauludyahwati and 2Yudha Nurdian
1
Student, Faculty of Medicine, University of Jember, Indonesia
2
Faculty of Medicine, University of Jember, Indonesia
Corresponding author: Luluk M., lulukmauludyah.lm@gmail.com; 152010101033@students.unej.ac.id

Abstract
Background
Microsporidia has been increasingly reported to infect humans. They have been increasingly
recognized as human pathogens in HIV+/AIDS patients. Among the microsporidial species,
Enterocytozoon bieneusi is the most prevalent human pathogenic species. Microsporidian spores are
commonly found in surface water. Transmission of E. bieneusi may involve person to-person as
well as environmental sources, such as ditch water, especially in developing countries with poor
sanitation. Most microsporidian infections are transmitted by oral ingestion of spores, with the
site of initial infection being the gastrointestinal tract. Chronic diarrhea is the most common clinical
manifestation in HIV+/AIDS patients with intestinal microsporidiosis; however, encephalitis, ocular
infection, sinusitis, myositis, and disseminated infection have also been describe. Many staining and
serological methods have been used for diagnosis of microsporidia infection, but molecular
techniques based on rRNA gene using Polimerase Chain Reaction (PCR) have been showed 100%
validity in detection and species identification of the parasite. HIV infection was confirmed by
Western blotting and AIDS phase also confirmed with CD4+ T cell count less than 200 per l of
peripheral blood. Because chronic microsporidiosis occurs primary in patients with advanced
immunodeficiency, all patients therefore should be offered antiretroviral (ART) as part of the initial
management of microsporidial infection. They should be given fluid to support if they have sign of
diarrhea and dehydration.

Conclusion
Microsporidial infection occurs in the HIV+/AIDS patients, especially in individuas with less than 200
per l of peripheral blood. The presentation classically involves chronic diarrhea. Supportive
treatment and optimization of ART to managing treatment.

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