Affiliations 

  • 1 Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Parasitology and Medical Entomology, Kuala Lumpur, Malaysia
  • 2 Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Penang, Malaysia
  • 3 Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Medicine, Kuala Lumpur, Malaysia
  • 4 Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Radiotherapy and Oncology, Kuala Lumpur, Malaysia
  • 5 Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Pathology, Kuala Lumpur, Malaysia
  • 6 Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Parasitology and Medical Entomology, Kuala Lumpur, Malaysia. emelia.osman@ukm.edu.my
Malays J Pathol, 2024 Aug;46(2):299-306.
PMID: 39207007

Abstract

Diagnosis of extraintestinal microsporidiosis is always hampered due to non-specific symptoms and difficulty in diagnosis. This study aimed to compare the diagnostic utility of blood and faecal-based polymerase chain reaction (PCR) to detect microsporidiosis in immunocompromised patients. A total of 42 immunocompromised patients consisting of HIV-infected and chemotherapy-treated patients were enrolled. Paired faecal and blood samples were collected and subjected to PCR to detect Enterocytozoon bieneusi and Encephalitozoon spp. Faecal samples were microscopically screened for microsporidia spores. Overall, 42.9% (18/42) of patients were positive for microsporidiosis. Of this, 19.0% (8/42) and 4.8% (2/42) were positive by blood and stool PCR respectively. Meanwhile, 33.3% (14/42) of the faecal specimens were microscopically positive. Among the positive patients, 22.2% (4/18) had microsporidia confirmed by blood PCR and stool microscopy, suggestive of dissemination. Interestingly, the stool specimen in which microsporidia spores were detected via microscopy is not positive via PCR method. This highlights the limitation of the faecal-based detection method and the important use of blood samples for diagnosing extraintestinal microsporidiosis. Only E. bieneusi species were detected in all PCR-positive samples. This study highlights the diagnostic value of blood PCR in diagnosing extraintestinal microsporidiosis infections.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.