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Description

Microsporidiosis is an opportunistic infection caused by obligate intracellular pathogens within the taxon Microsporidia. Infection is zoonotic and has been associated with patients experiencing immunodeficiency, though incidence is increasing among other populations. Most commonly, the disease is gastrointestinal, typically by Enterocytozoon bieneusi and less commonly by Encephalitozoon intestinalis. Symptoms present with diarrhea and vomiting, and severe cases can lead to wasting and mortality. While the incorporation of anti-retroviral therapy for HIV patients has significantly decreased mortality in a subset of the vulnerable populations, treatment for microsporidiosis is still not standardized or well explored. Resistance to first-line treatment albendazole is increasing, and another antiparasitic fumagillin is not approved as a systemic treatment in the US. Given that microsporidiosis is an emerging disease that affects the global population, there is an increasing need to educate clinicians about clinical presentation and to review treatment strategies and opportunities.

Disciplines

Gastroenterology | Infectious Disease | Medical Education | Medical Sciences | Medicine and Health Sciences | Parasitic Diseases | Primary Care

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Microsporidiosis: Reviewing clinical presentation and treatment strategies

Microsporidiosis is an opportunistic infection caused by obligate intracellular pathogens within the taxon Microsporidia. Infection is zoonotic and has been associated with patients experiencing immunodeficiency, though incidence is increasing among other populations. Most commonly, the disease is gastrointestinal, typically by Enterocytozoon bieneusi and less commonly by Encephalitozoon intestinalis. Symptoms present with diarrhea and vomiting, and severe cases can lead to wasting and mortality. While the incorporation of anti-retroviral therapy for HIV patients has significantly decreased mortality in a subset of the vulnerable populations, treatment for microsporidiosis is still not standardized or well explored. Resistance to first-line treatment albendazole is increasing, and another antiparasitic fumagillin is not approved as a systemic treatment in the US. Given that microsporidiosis is an emerging disease that affects the global population, there is an increasing need to educate clinicians about clinical presentation and to review treatment strategies and opportunities.