Myositis associated with a newly described microsporidian, Trachipleistophora hominis, in a patient with AIDS
Myositis associated with a newly described microsporidian, Trachipleistophora hominis, in a patient with AIDS
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DOI：
10.1128/jcm.34.11.2803-2811.1996
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发表时间：
1996-11-01
影响因子：
9.4
通讯作者：
Harkness, JL
中科院分区：
文献类型：
--
作者：
Field, AS;Marriott, DJ;Harkness, JL
微孢子虫是一种人畜共患的原虫，在1985年以前是罕见的人类病原体，当时在人类免疫缺陷病毒感染的慢性腹泻患者中发现了比氏肠细胞虫。另一个物种，脑胞虫，与腹泻和慢性鼻窦炎有关，文献中报道了大约25例。然而，人类免疫缺陷病毒感染患者的其他微孢子虫感染仍然极为罕见。我们报告了第一例单孢霉属的病例。如微孢子虫感染，表现为与发烧和体重减轻相关的进行性严重肌炎。通过光学显微镜和电子显微镜在角膜刮片、骨骼肌和鼻分泌物中证实了该微生物。电子显微镜显示，电子致密的表面涂层与''太阳耀斑''样的突起周围的所有阶段的发展meront（2至4个核，二分裂），孢子体，和孢子母细胞。孢子体的分裂，其中孢子体从厚的外被膜上分离，产生一个产孢子囊泡，是通过二分裂，将这种生物体与Pleistophora sp.区分开来。孢子大小为4.0 × 2.5 μ m，外孢子具皱纹。一个新的属和种，Trachipleistophora hominis，已经建立了这种寄生虫。患者接受阿苯达唑、磺胺嘧啶和乙胺嘧啶治疗，临床症状消退。
Microsporidia are zoonotic protozoa which were rare human pathogens prior to 1985, when Enterocytozoon bieneusi was described in human immunodeficiency virus-infected patients with chronic diarrhea. Another species, Encephalitozoon (Septata) intestinalis, is associated with diarrhea and chronic sinusitis, and approximately 25 cases have been reported in the literature. However, other microsporidial infections in human immunodeficiency virus-infected patients remain extremely rare. We report the first case of a Pleistophora sp.-like microsporidian infection presenting as a progressive severe myosotis associated with fever and weight loss. The organism was demonstrated by light microscopy and electron microscopy in corneal scrapings, skeletal muscle, and nasal discharge. Electron microscopy showed an electron-dense surface coat with ''sun-flare''-like projections surrounding all stages of development of meronts (two to four nuclei, dividing by binary fission), sporonts, and sporoblasts. Division of sporonts, in which sporonts separate from the thick outer coat, creating a sporophorous vesicle, is by binary fission, differentiating this organism from Pleistophora sp. The spore measures 4.0 by 2.5 mu m and has a rugose exospore. A new genus and species, Trachipleistophora hominis, has been established for this parasite. The patient was treated with albendazole, sulfadiazine, and pyrimethamine, and the clinical symptoms resolved.