Field A S, Marriott D J, Hing M C
Department of Anatomical Pathology, St. Vincent's Hospital, Darlinghurst, Sydney, Australia.
Folia Parasitol (Praha). 1993;40(4):261-6.
A protocol for the handling of small intestinal biopsies from HIV-infected patients is presented. This protocol includes the Warthin-Starry stain for the detection of microsporidia. This stain has proved a reliable and sensitive diagnostic technique for microsporidial infections as it stains both Enterocytozoon bieneusi and Septata intestinalis in duodenal enterocytes. Because the stain demonstrates Septata intestinalis in lamina propria macrophages as well as enterocytes, it allows for the practical differentiation of these two microsporidial infections. The Warthin-Starry stain has also demonstrated Septata intestinalis in nasal and colonic biopsies in some of these patients. Since the completion of an earlier study, a further 40 cases of Enterocytozoon bieneusi and three cases of Septata intestinalis have been diagnosed in just over 240 consecutive duodenal biopsies from HIV positive patients presenting with diarrhoea and other gastrointestinal complaints. Other opportunistic infections include cytomegalovirus in four cases, mycobacteria in eight cases, cryptosporidia in nine cases, giardia in four cases and Isospora belli in one case. Since the ratio of these opportunistic infections has remained much the same as in the previous study of 180 consecutive duodenal biopsies, we suggest that these rates may reflect the actual prevalence of microsporidial infections in AIDS patients in Sydney, Australia.
本文介绍了一种处理艾滋病病毒感染患者小肠活检样本的方案。该方案包括用于检测微孢子虫的Warthin-Starry染色法。这种染色法已被证明是一种可靠且灵敏的微孢子虫感染诊断技术，因为它能对十二指肠肠细胞中的比氏肠细胞内微孢子虫和肠内微孢子虫进行染色。由于该染色法能在固有层巨噬细胞以及肠细胞中显示肠内微孢子虫，所以可以实际区分这两种微孢子虫感染。Warthin-Starry染色法还在其中一些患者的鼻腔和结肠活检样本中显示出肠内微孢子虫。自一项早期研究完成以来，在连续240多例因腹泻和其他胃肠道症状前来就诊的艾滋病病毒阳性患者的十二指肠活检样本中，又诊断出40例比氏肠细胞内微孢子虫感染和3例肠内微孢子虫感染。其他机会性感染包括4例巨细胞病毒感染、8例分枝杆菌感染、9例隐孢子虫感染、4例贾第虫感染和1例贝氏等孢球虫感染。由于这些机会性感染的比例与之前对180例连续十二指肠活检样本的研究大致相同，我们认为这些发生率可能反映了澳大利亚悉尼艾滋病患者中微孢子虫感染的实际流行情况。
