Acute Invasive Rhinocerebral Zygomycosis in an Otherwise Healthy Patient: Case Report and Review

Abstract

The clinical manifestations of AIDS-related microsporidiosis range from mild or asymptomatic infections to debilitating illness involving the gastrointestinal, respiratory, or urogenital tracts or the eyes. Intestinobiliary infections with Enterocytozoon bieneusi are the most common microsporidial diseases, but disseminated infections with Encephalitozoon hellem, Encephalitozoon cuniculi, and Septata intestinalis are being increasingly recognized. The isolation of infective microsporidial spores from urine and respiratory secretions and the presence of spores in stool and duodenal aspirates suggest that person-to-person transmission may occur. Primary infection may also occur by inhalation or ingestion of spores from environmental sources or by zoonotic transmission. Development of guidelines for prevention of microsporidiosis will require that sources of infection and modes of transmission be more clearly elucidated. The presence of infective spores in bodily fluids, however, suggests that precautions when handling body fluids in clinical settings and personal hygiene measures such as hand washing may help to prevent primary infections.