Journal Article

Prevalence and Clinical Significance of Intestinal Microsporidiosis in Human Immunodeficiency Virus-Infected Patients With and Without Diarrhea in Germany: A Prospective Coprodiagnostic Study

Ingo Sobottka, David A. Schwartz, Justus Schottelius, Govinda S. Visvesvara, Norman J. Pieniazek, Christel Schmetz, Nico P. Kock, Rainer Laufs and Helmut Albrecht

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 26, issue 2, pages 475-480
Published in print February 1998 | ISSN: 1058-4838
Published online February 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516328
Prevalence and Clinical Significance of Intestinal Microsporidiosis in Human Immunodeficiency Virus-Infected Patients With and Without Diarrhea in Germany: A Prospective Coprodiagnostic Study

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The prevalence of intestinal microsporidiosis among human immunodefiency virus (HIV)-infected persons with chronic diarrhea varies from 7% to 50%; thus, microsporidia are a significant source of morbidity and, occasionally, mortality among these patients. Anecdotal reports suggest that intestinal microsporidiosis is also an important infection in patients with AIDS in Germany. To determine the prevalence of microsporidiosis among HIV-infected patients in Germany, we performed a prospective coprodiagnostic study of 97 consecutive HIV-infected patients. Microsporidia were the most common enteropathogen identified in 18 (36.0%) of 50 patients with diarrhea and 2 (4.3%) of 47 patients without diarrhea (P < .001; χ2 test). Microsporidia were present in 60% of patients with chronic diarrhea and 5.9% of patients with acute diarrhea. The etiologic agent was Enterocytozoon bieneusi in 18 patients and Encephalitozoon intestinalis in two patients. The prevalence of intestinal microsporidiosis in this cohort of German patients with AIDS and diarrhea is one of the highest to be reported anywhere in the world. Microsporidiosis seems to represent one of the most important causes of diarrhea in HIV-infected patients in Germany and thus must be considered in the differential diagnosis for all AIDS patients presenting with diarrhea.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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