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MICROSPORIDIOSIS IN TRAVEL-ASSOCIATED CHRONIC DIARRHEA IN IMMUNE-COMPETENT PATIENTS

We analyzed retrospectively 21 immune-competent travelers with chronic traveler’s diarrhea (3–6 weeks) after returning from recreational travel to the tropics with stool samples positive for microsporidia. Nine patients had been treated with albendazole and 12 patients had been treated symptomatically. Diarrhea resolved in 8 of 9 and 12 of 12 patients, respectively. In the albendazole group, Encephalitozoon intestinalis was cleared in 4 of 4 patients and Enterocytozoon bieneusi persisted in 7of 7 patients (2 patients were lost to follow-up). In the symptomatic treated group microsporidia persisted in stool samples of all patients. We conclude that there is only a transient correlation between detection of microsporidia in stool and gastrointestinal symptoms, and suggest that microsporidia infection may cause clinical symptoms during the early stages of infection that resolve even though the microsporidia may persist.

Received September 27, 2004. Accepted for publication February 26, 2005.

Acknowledgment: We thank the nursing staff of our department for continuous support.

^* Address correspondence to Christoph Wenisch, Medizinische Abteilung mit Infektions und Tropenmedizin, SMZ-Süd KFJ-Spital, Kundratstrasse 3, A-1100 Wien. E-mail: christoph.wenisch{at}wienkav.at

Authors’ addresses: Erika Wichro, David Hoelzl, Robert Krause, and Georg Bertha, Department of Internal Medicine, University Hospital Graz, Auenbruggerplatz 15, A-8036 Graz, Austria, Telephone: 43-316-385-81808, Fax: 43-316-385-4622. Franz Reinthaler, Institute of Hygiene, Medical University, Graz, Austria. Christoph Wenisch, Medizinische Abteilung mit Infektions und Tropenmedizin, SMZ-Süd-Kaiser Franz Josef Spital, Kundratstraße 3, A-1100 Wien, Telephone: 43-1-60191-2401, Fax: 43-1-60191-2419, E-mail: christoph.wenisch{at}wienkav.at.

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