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Chronic Microsporidial Enteritis in a Missionary from Mozambique

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  • Department of Microbiology Infectious and Emerging Diseases, and Department of Obstetrics and Gynecology, Edward Via College of Osteopathic Medicine, Blacksburg, Virginia; Department Biomedical Sciences and Pathobiology, Virginia Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia
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Microsporidiosis often occurs in immunocompromised persons but may also occur in those who are immunocompetent. Infection by Microsporidia involves a variety of organs and systems, most notably, intestine, lung, kidney, brain, sinuses, muscle, and eyes. Enterocytozoon bieneusi and Encephalitozoon intestinalis are associated with gastroenteritis, and Enterocytozoon hellem and Encephalitozoon cuniculi are associated with keratoconjunctivitis. We report a case of chronic microsporidiosis in a 28-year-old woman missionary from Mozambique who came to our diagnostic laboratory with nausea, lower abdominal pain, and frequent bowel movements. Over two years, the patient was clinically assessed and treated for malaria and giardiasis without laboratory diagnosis while in Mozambique. Identification of the causative agent of her condition was not attempted during the course of her illness in Mozambique. Furthermore, adverse effects of malaria and giardiasis medications may have exacerbated the chronic illness in this patient and mimicked chronic microsporidiosis.

Author Notes

*Address correspondence to James R. Palmieri, Department of Microbiology Infectious and Emerging Diseases, Edward Via College of Osteopathic Medicine, Blacksburg, VA 24060. E-mail: jpalmieri@vcom.edu

Authors' addresses: James R. Palmieri and Shaadi F. Elswaifi, Department of Microbiology Infectious and Emerging Diseases, Edward Via College of Osteopathic Medicine, Blacksburg, VA, E-mails: jpalmieri@vcom.vt.edu and selswaifi@vcom.vt.edu. David S. Lindsay, Department of Biomedical Sciences and Pathobiology, Virginia Maryland Regional College of Veterinary Medicine, Blacksburg, VA, E-mail: lindsayd@vt.edu. Gretchen Junko, Edward Via College of Osteopathic Medicine, Blacksburg, VA, E-mail: gjunko@vcom.vt.edu. Cathy Callahan, Department of Obstetrics and Gynecology, Edward Via College of Osteopathic Medicine, Blacksburg, VA, E-mail: ccallaha@vcom.vt.edu.

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