ABSTRACT
Abstract Microsporidia are obligate intracellular fungi with a remarkable ability to infect a wide range of invertebrate and vertebrate hosts. Namely, Enterocytozoon bieneusi is the most frequently microsporidia reported worldwide, and mainly associated with chronic diarrea and wasting syndrome in AIDS patients. Microscopy and PCR-based detection techniques are effective for diagnosis and identification of species and genotypes; however, these methods should be standardized in each laboratory. In this study, we performed microscopy and nested PCR techniques with PCR product sequencing to detect E. bieneusi in human stool samples. These techniques, if applied together, might prove useful for diagnosis and future epidemiological studies of intestinal microsporidiosis in Argentina.
Resumen Los microsporidios son hongos intracelulares obligados con una notable capacidad para infectar una amplia gama de hospedadores invertebrados y vertebrados. Enterocytozoon bieneusi es el microsporidio más frecuentemente reportado en todo el mundo, principalmente tricrómicaasociado con diarrea crónica y síndrome debilitante en pacientes con sida. Las técnicas dedetección basadas en microscopía y PCR son útiles para el diagnóstico y la identificación deespecies y genotipos, pero estos métodos deben estar estandarizados en cada laboratorio.En este estudio evaluamos técnicas de microscopía y PCR anidada, con secuenciación de losproductos, para detectar E. bieneusi en muestras de heces humanas. Estas técnicas, usadas con-juntamente, podrían ser útiles para su aplicación en el diagnóstico de microsporidiosis intestinaly para realizar estudios epidemiológicos de esta afección en Argentina.
Subject(s)
Humans , Microsporidia , Enterocytozoon , Spores, Fungal , Polymerase Chain Reaction , Microsporidia/genetics , Enterocytozoon/genetics , FecesABSTRACT
Chagas' disease caused by "Trypanosoma cruzi" (T. cruzi), is well recognized as an opportunistic infection in the setting of HIV / AIDS. More patients with Chagas' disease, live in countries of Central and South America, That's why, it is also called "American Trypanosomiasis ". T. cruzi is mainly transmitted by vectors ("Triatoma infestans" in Argentina) specially in the "endemic american area" and secondarily, by blood transfusion, not only in America, but also in the rest of the world. Many people have migrated from the endemic area of America to others countries around the world. Perhaps, some of them were asyntomatic "chagasic" patients and may have transmitted T. cruzi by blood transfusions in those non-endemic areas.. So that, Chagas' disease should be considered nowadays, as a "global pathology". In severely inmunocompromissed patients with AIDS, chronic Chagas' disease may have reactivated, affecting central nervous system (CNS) with brain mass lesions (called "chagomas"), similar to others necrotizing encephalitis like Toxoplasmosis.. We report a 32 year-old woman assisted in the Rawson Hospital of Córdoba City (Argentina), with AIDS and reactivation of Chagas' disease. Patient coming from Catamarca (north-western region of Argentina) with severe headache, unisocoria, desorientation in time and space, fine tremor, nistagmus, clonus, hiperreflexia and fascial-braquial-crural hemiparesia. Patient was afebrile and the rest of physical examination was normal. She had low count of CD4 cells and high HIV-viral load. Magnetic resonance imagin (MRI) showed: several enhanced rounded lesions surrounded by edema along the whole brain. Treatment with sulfadiacina + Pyrimethamine and Dexametasone, for a presuntive cerebral toxoplasmosis was implemented but, patient did not improve. So, cerebral biopsie was performed and it showed: intra and extracellular " AMASTIGOTES" of T. cruzi..Treatment with Benznidazol was prescribed, but in a few days, patient died.