Table 1.
Microsporidiosis in transplant recipientsa
| Case (reference[s]) | Type of transplant (no. of patients) | Age (yr) | Gender (no. of patients) | Species/genotype (no. of patients) | Immunosuppressive treatment agent(s) | Clinical manifestation(s) | Laboratory diagnosis method(s) | Treatment/outcome | Country/Publication yr |
|---|---|---|---|---|---|---|---|---|---|
| 1b (25) | Kidney (6); liver (1); heart-lung (1) | E. bieneusi/C (7) and D (1) | NA | Diarrhea | MTS, PCR, PCR-RFLP | NA | France/2001 | ||
| 2b (35) | Kidney (14); liver (5); heart and/or lung (4) | F (7); M (16) | NA | ATG, CS, AZ, MMF, tacrolimus | Asymptomatic, diarrhea, wt loss | PCR, TEM | Albendazole, fumagillin | France/2003 | |
| 3b (46) | Kidney (5) | F (2); M (3) | E. bieneusi/C | NA | NA | PCR | NA | Netherlands/2009 | |
| 4 (40) | Liver | 48 | F | Undetermined | Tacrolimus, prednisone | Intestinal | MTS | Metronidazole/recovery | U.S./1995 |
| 5 (34) | Heart; lung | 48 | M | E. bieneusi | CS, AZ, methylprednisone | Intestinal | MTS, TEM | Metronidazole/recovery | France/1996 |
| 6 (20) | Bone marrow | 27 | F | Undetermined | l-Asparaginasa, vincristin, daunomycine, prednisone, CS | Intestinal, respiratory | TEM | India/1997 | |
| 7 (16) | Kidney | 46 | M | E. bieneusi | AZ, CS, prednisone, MMF | Intestinal | MTS, PCR | Albendazole/recovery | France/1999 |
| 8 (16) | Kidney | 24 | M | E. bieneusi | Thymoglobuline, prednisone, CS, AZ, MMF | Intestinal | MTS, PCR | France/1999 | |
| 9 (17) | Heart | 48 | M | E. bieneusi | CS, AZ, methylprednisone | Intestinal | MTS | U.S./1999 | |
| 10 (29) | Kidney | 38 | F | E. bieneusi | Tacrolimus, prednisone, MMF | Intestinal | MTS, PCR | Albendazole, metronidazole/recovery | France/2000 |
| 11 (41) | Liver | 36 | F | E. bieneusi/C | Tacrolimus | Intestinal | MTS, PCR | Albendazole/ E. bieneusi persistence | Germany/2001 |
| 12 (15) | Liver | 36 | F | E. bieneusi | Tacrolimus | Intestinal | MTS, PCR-RFLP | Albendazole/symptomatic improvement, E. bieneusi persistence | Germany/2001 |
| 13 (23) | Kidney | 39 | M | Encephalitozoon sp. | AZ, CS, Prednisone | Fever, renal impairment | GCS, TEM | Albendazole/recovery | South Africa/2001 |
| 14 (30) | Kidney | 43 | F | E. cuniculi/type III strain | Methylprednisone | Disseminated | GCS, IFAT, TEM, PCR | Albendazole, topical fumagillin (keratitis)/death related to neurological involvement | Canada/2002 |
| 15 (31) | Liver | NA | E. bieneusi | Tacrolimus | NA | MTS, PCR | Fumagillin/recovery | France/2002 | |
| 16 (31) | Kidney | NA | E. bieneusi | Tacrolimus, prednisone | NA | MTS, PCR | Fumagillin/recovery | France/2002 | |
| 17 (14) | Kidney | 42 | M | E. cuniculi | Rapamycin, CS, prednisone | Disseminated | IFAT, TEM | Albendazole, fumagillin/relapse 1 year later | Mexico/2003 |
| 18 (28) | Kidney | 45 | F | E. cuniculi | Steroids | Disseminated | PCR, TEM | Antimicrobial therapy/death | U.S./2003 |
| 19 (33, 45) | Bone marrow | 21 | F | E. cuniculi/type III strain | Thiotepa, CYP, ATG, CS | Pulmonary | MTS, TEM, PCR | NA | U.S./2004-2005 |
| 20 (4) | Pancreas; kidney | 43 | M | Encephalitozoon sp. | Tacrolimus, MMF, prednisone, AZ | Disseminated | TEM | Postmortem diagnosis | U.S./2004 |
| 21 (19) | Cornea | 60 | M | Undetermined | Prednisolone acetate | Keratoconjunctivitis | CW, GS, PCR | Topical ciprofloxacin | India/2006 |
| 22 (22) | Kidney | 64 | M | E. bieneusi | Tacrolimus, MMF | Intestinal | Uvitex-2B, PCR | France/2009 | |
| 23 (22) | Liver | 45 | M | E. bieneusi | CS, everolimus | Intestinal | HE, Uvitex-2B, PCR | France/2009 | |
| 24 (44) | Kidney | 38 | F | E. cuniculi/type IV strain | Thymoglobuline, MMF, CsA | Disseminated | Uvitex-2B, PCR | Albendazole/recovery | France/2010 |
| Current report | Kidney | 66 | M | E. bieneusi /D | Steroids, tacrolimus, MMF | Intestinal | MTS, PCR | Filgrastrim/recovery | Spain |
| Current report | Kidney | 54 | M | E. bieneusi /D | Tacrolimus, MMF | Intestinal | MTS, PCR | Albendazole, metronidazole/recovery | Spain |
a
F, female; M, male; CS, cyclosporine; AZ, azathioprine; MMF, mycophenolate mofetil; CsA, cyclosporine A; Cyp, cyclophosphamide; ATG, antilymphocyte globulin; MTS, modified trichrome stain; RFLP, restriction fragment length polymorphism; GCS, Gram chromotrope stain; HE, hematoxylin-eosin stain; TEM, transmission electron microscopy; IFA, indirect immunofluorescence assay; PCR, polymerase chain reaction; CW, calcofluor white; GS, Gram stain; NA, not available; ND, not determined.
b
Retrospective study.