Article

Microsporidiosis and Transplantation: A Retrospective Study of 23 Cases

[ "Corresponding author: M. Rabodonirina. Telephone: +33 4 72 07 19 41; Fax: + 33 4 72 07 18 73; "]; [ "Service de Parasitologie"]; [ "Service d'Hépatogastro-Entérologie, Hôpital de la Croix-Rousse"]; [ "Service d'Hépatogastro-Entérologie, Hôpital de l'Hôtel-Dieu. Hospices Civils de Lyon, Lyon, France"]
Journal of Eukaryotic Microbiology (impact factor: 2.66). 01/2009; DOI:10.1368/1066-5234(2003)050[0583:MATARS]2.0.CO;2 pp.583-583
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  • Article: Waterborne outbreak of intestinal microsporidiosis in persons with and without human immunodeficiency virus infection.
    L Cotte, M Rabodonirina, F Chapuis, F Bailly, F Bissuel, C Raynal, P Gelas, F Persat, M A Piens, C Trepo
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    ABSTRACT: Among 1454 persons whose stool samples (n=5692) were submitted to a reference laboratory for microsporidia assessment from 1993 to 1996, microsporidia were identified in 338 persons: 261 persons infected with human immunodeficiency virus (HIV), 16 transplant patients, and 61 others. Intestinal microsporidiosis appears to be an endemic disease in HIV-positive persons (prevalence, 0.1%) and a sporadic disease in HIV-negative persons (prevalence, <1/1 million). A waterborne outbreak in 200 persons (attack rate, 1% in HIV-positive patients/month) occurred in the 1995 summer, without evidence of fecal contamination of water. No explanation was found before the outbreak ended, several months before the antiprotease era. Factors associated with microsporidiosis diagnosis were HIV infection, male homosexuality, low CD4 cell counts, and diarrhea. The major factor associated with a diagnosis of microsporidiosis during the outbreak was living in an area corresponding to one of the three water distribution subsystems of the town. Lake contamination was suspected.
    The Journal of Infectious Diseases 12/1999; 180(6):2003-8. · 6.41 Impact Factor
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    Article: Intestinal microsporidiosis occurring in two renal transplant recipients treated with mycophenolate mofetil.
    A Guerard, M Rabodonirina, L Cotte, O Liguory, M A Piens, S Daoud, S Picot, J L Touraine
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    ABSTRACT: Intestinal microsporidiosis is a major cause of chronic diarrhea and malabsorption in patients with human immunodeficiency virus. Its occurrence in transplant recipients has exceptionally been reported to date. We report what we believe are the first two cases of intestinal microsporidiosis in renal transplant recipients. The patients were treated with mycophenolate mofetil. The clinical presentation was chronic diarrhea with massive weight loss. Stool analysis revealed microsporidian spores, identified as Enterocytozoon bieneusi spores by polymerase chain reaction. The onset of this opportunistic infection in these two patients is believed to be secondary to an increase in immunosuppression after azathioprine replacement by mycophenolate mofetil. The withdrawal of mycophenolate mofetil led to clinical recovery. The incidence of microsporidiosis will probably increase in transplant recipients treated with powerful immunosuppressants. Therefore, we recommend a systematic search for microsporidian spores in stool specimens in cases of unexplained diarrhea in these patients.
    Transplantation 10/1999; 68(5):699-707. · 4.00 Impact Factor
  • Enterocytozoon bieneusi as a cause of chronic diarrhea in a heart-lung transplant recipient who was seronegative for HIV. M Rabodonirina, M Bertocchi, I Desportes, L Livage, H Cotte, M A Levrey, G Piens, M Monneret, J F Celard, M Mornex, Mojon . 1996. Clin. Infect. Dis 23 114-117.
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