P-1609. Microsporidiosis in Solid Organ Transplant Recipients: Efficacy of Short Course Fumagillin Therapy and Review
Session: Poster Session: Protozoa Other than Malaria and Babesia
Sunday, October 26, 2008: 12:00 AM
Room: Hall C
Background: Microsporidia were initially described as opportunistic microorganisms in AIDS patients. They are now emerging pathogens responsible for severe diarrhea during solid organ transplantation. Two main clinical entities can be individualized: infection by Enterocytozoon bieneusi causing diarrhea with limited treatment options and infection by Encephalitozoon intestinalis, which may disseminate and usually responds to albendazole treatment. Methods and Results: We describe here two cases of microsporidiosis caused by E. bieneusi in a renal and a liver transplant recipient, respectively, in whom a complete clinical efficacy of a short course fumagillin therapy was obtained. Long-term microbiological eradication was assessed using classical methods and monitored using a qRT-PCR-based method. Both patients presented drug-induced thrombocytopenia, resolutive after treatment’s withdrawal. We also review the 18 other previously reported microsporidiosis cases in transplant recipients. Conclusions: In case of persistent diarrhea in solid organ transplant patients, microsporidiosis should be considered. Based on the present experience, treating E. bieneusi infection with 10 days fumagillin therapy is adequate to eradicate E. bieneusi in this context.
C Sarfati1, David Boutboul2, Fanny Lanternier, MD3, Frédéric Mechai4, Jean Menotti1, Jean Paul Viard2, Marc Lecuit, MD PhD5, Marie Elisabeth Bougnoux2, Marie France Mamzer Bruneel2, Marie Olivia Chandesris2, Olivier Lortholary, MD, PhD6, Yvon Calmus7 and  F. Lanternier, None., (1)Hopital Saint Louis, (2)Hopital Necker Enfants malades, (3)Cochin Hospital, Paris, France, (4)AP-HP, (5)Institut Pasteur, Paris, France, (6)AP-HP; Univ. Paris V, (7)Hopital Cochin