Acalculous Cholecystitis Associated with Microsporidial Infection in a Patient with AIDS

In recent years the microsporidial species Enterocytozoon bieneusi has been reported to be pathogenic in multiple cases of AIDS-related cholangitis. We describe a patient with AIDS who developed a case of acalculous cholecystitis in which E. bieneusi was the only identifiable pathogen. A 37-year-old...

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Bibliographic Details
Published in:Clinical infectious diseases 1996-01, Vol.22 (1), p.195-196
Main Authors: Knapp, P. E., Saltzman, J. R., Fairchild, P.
Format: Article
Language:English
Subjects:
Acalculous cholecystitis
Adult
AIDS
AIDS-Related Opportunistic Infections - microbiology
AIDS-Related Opportunistic Infections - physiopathology
AIDS/HIV
Animals
Biological and medical sciences
Brief Reports
Cholangitis
Cholecystitis - complications
Cholecystitis - parasitology
Cholecystitis - physiopathology
Diarrhea
Enterocytozoon bieneusi
Follow-Up Studies
Gallbladder
human immunodeficiency virus
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infections
Male
Medical sciences
Microsporida - isolation & purification
Microsporidia
Microsporidiosis - complications
Microsporidiosis - parasitology
Microsporidiosis - physiopathology
Pathogens
Patient assessment
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Summary:In recent years the microsporidial species Enterocytozoon bieneusi has been reported to be pathogenic in multiple cases of AIDS-related cholangitis. We describe a patient with AIDS who developed a case of acalculous cholecystitis in which E. bieneusi was the only identifiable pathogen. A 37-year-old male with no significant medical history and no reported risk factors for HIV infection presented to the University of Massachusetts Medical Center (Worcester, MA) with a 6-month history of watery diarrhea. He also had persistent pain in the right upper quadrant and reported a weight loss of 42 pounds. He was found to be seropositive for HIV and to have a CD4 super(+) cell count of 130/mm super(3). A sphincterotomy was performed, and cultures of the aspirated bile revealed the presence of microsporidia organisms with no evidence of CMV, Cryptosporidium species, or other pathogens. Following the procedure the patient's right upper-quadrant pain and fever resolved. Several months later he was readmitted to the hospital with a fever of 39 degree C, nausea, vomiting, diarrhea, and worsening tenderness in the right upper quadrant. A laparoscopic cholecystectomy was performed, and pathological examination of the gallbladder revealed inflammatory changes consistent with chronic acalculous cholecystitis and diffuse intracellular microsporidia organisms. At a 10-month follow-up examination, the patient remained free of right upper-quadrant pain.
ISSN:1058-4838
1537-6591
DOI:10.1093/clinids/22.1.195