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Open Access Case report

Cerebral microsporidiosis manifesting as progressive multifocal leukoencephalopathy in an HIV-infected individual - a case report

Maude Loignon1*, Louise-Geneviève Labrecque12, Céline Bard3, Yves Robitaille4 and Emil Toma12*

Author Affiliations

1 Département de microbiologie, Infectiologie, immunologie-Université de Montréal, Montréal, Canada

2 Département de microbiologie et infectiologie, Centre hospitalier de l’université de Montréal (CHUM), Montréal, Canada

3 Déparetment de radiologie et médicine nucléaire-CHUM, Montréal, Canada

4 Département de pathologie, Hôpital Sainte-Justine, Montréal, Québec, Canada

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AIDS Research and Therapy 2014, 11:20  doi:10.1186/1742-6405-11-20

Published: 15 July 2014

Abstract

Microsporidia have become increasingly recognized as opportunistic pathogens since the genesis of the AIDS epidemic. The incidence of microsporidiosis has decreased with the advent of combination antiretroviral therapy but it is frequently reported in non-HIV immunosuppressed patients and as a latent infection in immunocompetent individuals. Herein, we describe an HIV-infected male (46 years) with suspected progressive multifocal leukoencephalopathy that has not responded to optimal antiretroviral therapy, steroids, or cidofovir. Post-mortem examination revealed cerebral microsporidiosis. No diagnostic clue however, was found when the patient was alive. This report underscores the need for physicians to consider microsporidiosis (potentially affecting the brain) when no other etiology is established both in HIV, non-HIV immunosuppressed patients and in immunocompetent individuals.

Keywords:
Microsporidiosis; Cerebral lesions; HIV; Progressive multifocal leukoencephalopathy