Schwartz D A, Abou-Elella A, Wilcox C M, Gorelkin L, Visvesvara G S, Thompson S E, Weber R, Bryan R T
Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA.
Arch Pathol Lab Med. 1995 May;119(5):424-8.
Enterocytozoon bieneusi is the most frequently reported microsporidial infection of humans. In patients with the acquired immunodeficiency syndrome, Enterocytozoon infects the lining epithelial cells of the small intestine, hepatobiliary tract, and gallbladder. Because Enterocytozoon has been thought to be limited to infecting lining epithelial cells, the mechanism of spread of E bieneusi within the intestine, to the biliary tract, and, in two case reports, to distant organs remains unknown. This report describes a patient with acquired immunodeficiency syndrome and intestinal microsporidiosis due to E bieneusi. Histopathologic examination of well-oriented biopsies from the duodenum and jejunum revealed both intra- and extracellular spores of Enterocytozoon extending deeply into the lamina propria, where they were located adjacent to capillaries. The patient has not developed disseminated disease 20 months after the initial diagnosis. In this patient, the demonstration of E bieneusi spores in extraepithelial tissues does not appear to be associated with development of subsequent systemic infection.
人芽囊原虫是最常报道的人类微孢子虫感染病原体。在获得性免疫缺陷综合征患者中，人芽囊原虫感染小肠、肝胆管和胆囊的内衬上皮细胞。由于人芽囊原虫一直被认为仅限于感染内衬上皮细胞，因此，人芽囊原虫在肠道内传播至胆道，以及在两例病例报告中传播至远处器官的机制仍不清楚。本报告描述了一名因感染人芽囊原虫而患有获得性免疫缺陷综合征和肠道微孢子虫病的患者。对十二指肠和空肠的定向活检进行组织病理学检查发现，人芽囊原虫的胞内和胞外孢子深入固有层，位于毛细血管附近。在初次诊断20个月后，该患者未发生播散性疾病。在该患者中，上皮外组织中人芽囊原虫孢子的存在似乎与随后发生的全身感染无关。
