Microsporidiosis is an infection with microsporidia. Experienced symptomatic infection occurs mostly in AIDS patients, the symptoms consist u. a. from chronic diarrhea, disseminated infection and corneal diseases. The diagnosis is made by detecting the pathogen in biopsy samples, stool, urine, other secretions or Korneageschabsel. The treatment is carried out with albendazole or fumagillin (depending on the type of infecting and clinical symptoms) in an eye disease fumagillin is added.

Microsporidia are obligate intracellular parasite spore-forming. At least 15 of> 1,200 species are associated with human disease. The spores of the pathogen is transmitted by ingestion, inhalation, direct contact with the conjunctiva or human-to-human contact. In the host, they anchor themselves in the host cell with its polar tubule or thread and inoculate them with an infectious sporoplasm. Intracellularly divide and multiply the Sporoplasmen produce sporoblasts that mature into spores. The spores can disseminate throughout the body and are excreted with respiratory aerosols, stool or urine into the environment. An inflammatory reaction occurs in release of spores from host cells.

Microsporidiosis is an infection with microsporidia. Experienced symptomatic infection occurs mostly in AIDS patients, the symptoms consist u. a. from chronic diarrhea, disseminated infection and corneal diseases. The diagnosis is made by detecting the pathogen in biopsy samples, stool, urine, other secretions or Korneageschabsel. The treatment is carried out with albendazole or fumagillin (depending on the type of infecting and clinical symptoms) in an eye disease fumagillin is added. Microsporidia are obligate intracellular parasite spore-forming. At least 15 of> 1,200 species are associated with human disease. The spores of the pathogen is transmitted by ingestion, inhalation, direct contact with the conjunctiva or human-to-human contact. In the host, they anchor themselves in the host cell with its polar tubule or thread and inoculate them with an infectious sporoplasm. Intracellularly divide and multiply the Sporoplasmen produce sporoblasts that mature into spores. The spores can disseminate throughout the body and are excreted with respiratory aerosols, stool or urine into the environment. An inflammatory reaction occurs in release of spores from host cells. Little is known about transmission paths that lead to human infection, and possible animal reservoirs. Microsporidia are probably a common cause of subclinical or mild self-limiting disease in otherwise healthy individuals, in the pre-AIDS era, however, was reported only a few cases of human infections, which was possibly due to a lack of awareness about Mikrosporidieninfektionen the case. Lately microsporidia keratoconjunctivitis has been increasingly reported in immunocompetent people. Microsporidia occurred as opportunistic pathogens in patients with AIDS and, to a lesser extent, in other immunocompromised patients. Encephalitozoon bieneusi and E. (formerly Septata) intestinalis may occur in patients with AIDS and <100 / ul perform CD4 + cell numbers to chronic diarrhea. Microsporidia can also use the biliary tract, cornea, muscles, the respiratory tract, the genitourinary system and occasionally infest the CNS. The symptoms and discomfort caused by microsporidia clinical picture varies depending on the species of parasite and the immune status of the host. In AIDS patients, different species cause chronic diarrhea, malabsorption, wasting, cholangitis, punctate keratoconjunctivitis, peritonitis, hepatitis, myositis or sinusitis. It came from infections of the kidneys and gallbladder. Vittaforma (Nosema) corneum and various other species can cause ocular infections that range from a point keratopathy with redness and irritation to severe that sight hazardous stromal keratitis. Diagnostic light or electron microscopy with special stains The infectious agent can in biopsy samples of the affected tissue or be detected in Korneageschabsel stool, urine, cerebrospinal fluid, sputum or. Microsporidia can best be seen in the use of special staining techniques. Fluorescent brightening agent (fluorochrome) may be employed for the detection of spores in tissue samples and smears. The "quick-hot Gram chromothrope technology" is the fastest-specific test. Immunoassay and PCR-based methods are promising for the future. Transmission electron microscopy is currently the zuverlässisgste test and is used to differentiate. Therapy in patients with AIDS initiation or optimization of antiretroviral therapy (ART) In gastrointestinal, skin, muscle or disseminated Mikrosporidiosis oral albendazole or fumagillin (where available) as a function of the infecting species In keratoconjunctivitis albendazole oral and topical In fumagillin gastrointestinal Mikrosporidiosis can be effective for the control of diarrhea caused by E. intestinalis (for weeks in adults 400 mg orally two times a day) albendazole. The substance reduces the number of pathogens in the small intestine biopsies, the infection but not eliminated. Albendazole 400 mg p.o. Skin, muscle or disseminated Mikrosporidiosis was 2 times daily for weeks to treat by E. intestinalis and numerous other microsporidia caused applied. Albendazole 400 mg p.o. in combination with itraconazole 400 mg po 2 times a day has been used in Trachipleistophora- and Anncaliia infections daily. Albendazole is not active against E. bieneusi and V. corneum. the duration of treatment and the prognosis on the level of immune reconstitution depend on ART in patients with AIDS. Oral fumagillin 20 mg 3 times daily for 14 days bieneusi infections is at intestinal E. been used, but it has potentially serious side effects, including severe reversible thrombocytopenia in up to half of patients. In the US, oral fumagillin is not available. Ocular microsporidia can keratoconjunctivitis with albendazole 400 mg p.o. (Every 2 hours for 4 days, then 2 drops four times daily 2 drops) are treated two times a day plus fumagillin eye drops 3 mg / ml. Topical fluoroquinolones have been effective in some patients. If a topical and systemic therapy are ineffective, a keratoplasty can be useful. The prognosis is very good in immunocompetent patients generally; in patients with AIDS it depends on the level of immune reconstitution with ART. Important points Mikrosporidiosis primarily occurs in immunocompromised patients, particularly those with AIDS, but keratoconjunctivitis has been increasingly reported in otherwise healthy people. Microsporidia spores can be transmitted through ingestion, inhalation, direct contact with the conjunctiva or human-to-human contact. The manifestations vary greatly depending on the organism and the immune status of patients, but chronic diarrhea, malabsorption, wasting, cholangitis, punctate keratoconjunctivitis, peritonitis, hepatitis, myositis, or sinusitis can occur. To diagnose a light or electron microscopy is applied with special stains; DNA-based tests are useful but not widely available. In patients with AIDS, the introduction or optimization of ART is of prime importance. Albendazole and oral or topical fumagillin can be useful, depending on the infecting species and the organs involved; oral fumagillin is not available in the US.

Health Life Media Team

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