H. Moura

Gram-Chromotrope: a New Technique that Enhances Detection of Microsporidial Spores in Clinical Samples

We have developed a new staining procedure that combines the traditional Gram staining for bacteria and the Webers chromotrope staining method, the standard technique for the detection of microsporidia spores in clinical Specimens. This “Gram‐chromotrope” staining technique enhances the staining characteristics of microsporidia spores and facilitates the easy detection and differentiation of spores from other microorganisms that are found in clinical specimens, especially stool samples. This new technique is fast, reliable, and simple to perform, and can be easily adapted for use in clinical laboratories.

Clinical and diagnostic aspects of intestinal microsporidiosis in HIV-infected patients with chronic diarrhea in Rio de Janeiro, Brazil

The objectives of this study were to determine both the prevalence of microsporidial intestinal infection and the clinical outcome of the disease in a cohort of 40 HIV-infected patients presenting with chronic diarrhea in Rio de Janeiro, Brazil. Each patient, after clinical evaluation, had stools and intestinal fragments examined for viral, bacterial and parasitic pathogens. Microsporidia were found in 11 patients (27.5%) either in stools or in duodenal or ileal biopsies. Microsporidial spores were found more frequently in stools than in biopsy fragments. Samples examined using transmission electron microscopy (n=3) or polymerase chain reaction (n=6) confirmed Enterocytozoon bieneusi as the causative agent. Microsporidia were the only potential enteric pathogens found in 5 of the 11 patients. Other pathogens were also detected in the intestinal tract of 21 patients, but diarrhea remained unexplained in 8. We concluded that microsporidial infection is frequently found in HIV infected persons in Rio de Janeiro, and it seems to be a marker of advanced stage of AIDS.

Isolation of free-living amoebae from bottled mineral water

Foram isoladas amebas dos generos Vahlkampfia, Glaeseria, Acanthamoeba, Filamoeba, Amoeba, Platyamoeba e Hartmanella de dez diferentes marcas de agua mineral engarrafadas, servidas no Rio de Janeiro, RJ (Brasil). Somente uma das marcas foi negativa para protozoarios, enquanto que de todas as outras foram isoladas amebas de vida livre. O significado desses resultados e discutido como um indicador de qualidade da agua mineral usada comercialmente, destacando-se o fato de que alguns desses microorganismos sao potencialmente patogenicos.

Amebas de vida livre no intestino humano: evidências de parasitismo

Cultures for free-living amoebae were made from feces of 620 individuals of which 514 were patients from the University Hospital Pedro Ernesto (Rio de Janeiro) and, 106 were children and adults of an orphanage. Positive results were obtained in 70 specimens (11.2%), 55 from the hospital patients and 15 from the orphanage. 60 Acanthamoeba, 6 Vahlkampfia, 5 Hartmannella and, 1 Echinamoeba were isolated. Some individuals were repeatedly positive for Acanthamoeba during the 2 months of observation. Of the isolated Acanthamoeba, 28 were inoculated intranasally. 16 Strains (57.1%) were reisolated from brain and or lungs of the animals. The histopathology revealed an acute inflammatory process with polymorphonuclear neutrophils and amoebae in the brain and lungs of some of the animals. The isolation of pathogenic strains of Acanthamoeba from human feces supports the hypothesis of eventual development, in carriers, of granulomatous amebic meningoencephalitis as an opportunistic endogenous infection.

A 3-year follow-up of a brazilian AIDS patient with protracted diarrhea caused by Enterocytozoon bieneusi

Enterocytozoon bieneusi is the most prevalent microsporidian parasite that causes gastrointestinal infection in persons with AIDS. Microsporidia are increasingly recognized as important opportunistic pathogens all over the world but in Brazil only few cases have been reported due either to the non awareness of the clinical presentation of the disease or to difficulties in the laboratory diagnosis. We report a 3-year follow-up of a Brazilian HIV-positive patient in whom microsporidial spores were detected in stools and were identified as E. bieneusi using electron microscopy and PCR. The patient presented with chronic diarrhea, CD4 T-lymphocytes count below 100/mm3 and microsporidial spores were consistently detected in stools. Albendazole was given to the patient in several occasions with transient relief of the diarrhea, which reappeared as soon as the drug was discontinued. Nevertheless, a diarrhea-free period with weight gain up to 18 Kg occurred when a combination of nucleoside and protease inhibitors was initiated as part of the antiviral treatment.

Ocorrência de Cryptosporidium sp em amostras fecais de crianças, menores de 10 anos de idade, com indicação clínica de Rotavírus

The presence of oocysts of Cryptosporidium sp was investigated in 485 fecal samples of children with clinical indication of Rotavirus. No significant differences were observed between Cryptosporidium sp. and rotavirus occurrence and fecal consistency. Cryptosporidium sp also should be performed in the laboratory diagnosis of diarrheic episodes in children.

Microsporidiose humana na síndrome de imunodeficiência adquirida

OURADisciplinas de Doencas Infecciosas e Parasitarias e de Parasitologia da Faculdade de Ciencias Medicas do Hospital Universitario PedroErnesto, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ.Tabela 1 — Classificacao dos microsporidiaPhylum MicrosporaClasse MicrosporeaOrdem MicrosporidiaSubordem Pansporoblastina ApansporoblastinaGeneros Pleistophora NosemaSeptata EnterocytozoonEncephalitozoonEspecies S. intestinalis * N. connoriN. corneumE. bieneusiE. cuniculiE. hellem