Identification of two potential aetiological agents of chronic diarrhoea in an immunocompromised patient in Cuba using conventional and molecular diagnostic techniques

• Published in: Journal of microbiological methods 2022-01, Vol.192, p.106376-106376, Article 106376
• Main Authors: Jerez Puebla, Luis Enrique, Núñez Fernández, Fidel A., Atencio Millán, Iraís, Pérez Avila, Jorge, Fraga Nodarse, Jorge, Cruz Rodríguez, Iredys, Rodríguez Moreno, Laura, Fresco Sampedro, Yanet, Robertson, Lucy J.
• Format: Article
• Language: English
• Subjects: Adult; Anti-Infective Agents - therapeutic use; Coccidia; Coccidiosis - diagnosis; Coccidiosis - drug therapy; Cuba; Diarrhea - diagnosis; Diarrhea - microbiology; Diarrhea - parasitology; Diarrhoea; Enterocytozoon - genetics; Enterocytozoon - isolation & purification; HIV; HIV Infections - complications; HIV Infections - drug therapy; Humans; Immunocompromised Host; Male; Microscopy; Microsporidia; Microsporidiosis - diagnosis; Microsporidiosis - drug therapy; Molecular assay; Molecular Diagnostic Techniques; Polymerase Chain Reaction; Sarcocystidae - genetics; Sarcocystidae - isolation & purification; Sarcoma, Kaposi - complications; Sarcoma, Kaposi - drug therapy; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use
• ISSN: 0167-7012; 1872-8359
• DOI: 10.1016/j.mimet.2021.106376

The aetiology of diarrhoea in a patient in Cuba with HIV was investigated. Although molecular diagnostics are still not used in many under-resourced settings, here traditional methods were supported by use of PCR. This approach enabled detection of a dual infection (Cystoisospora belli and Enterocytozoon bieneusi), the latter of which was not identified by microscopy with Didier's trichromic staining. •An HIV patient presented with persistent diarrhoea of unknown cause.•Cystoisospora belli was identified by microscopy, but no other pathogens.•Molecular techniques were confirmatory, but also identified Enterocytozoon bieneusi.•The patient responded well to TMP-SMX therapy, but follow-up is advised.•Mixed infections should be considered, even when one pathogen has been identified.