Journal of Gastrointestinal Cancer

, Volume 39, Issue 1–4, pp 124–129 | Cite as

Incidence of Microsporidia in Cancer Patients

  • Angela R. Lono
  • Suresh Kumar
  • Tan T. Chye



Microsporidia are considered opportunistic pathogens as evidenced by the significant detection in immunocompromised HIV/AIDS population. Cancer patients receiving chemotherapy are considered to be immunosuppressed.

Materials and Methods

Stool samples were collected from 311 cancer patients in the Klang Valley. Each sample underwent water–ether concentration and staining with modified trichrome stain.

Results and Discussion

Sixty-eight samples were positive by oil immersion examination. Polymerase chain reaction amplification with specific primers on those samples amplified Encephalitozoon intestinalis from two of the samples and Encephalitozoon hellem from one sample.


microsporidia cancer E. intestinalis E. hellem 


  1. 1.
    Abaza SM, Makhlouf LM, el-Shewy KA, el-Moamly AA. Intestinal opportunistic parasites among different groups of immunocompromised hosts. J Egypt Soc Parasitol. 1995;25:713–27.PubMedGoogle Scholar
  2. 2.
    Ashton N, Wirasinha PA. Encephalitozoonosis (Nosematosis) of the cornea. Br J Ophthal. 1973;57:669–74. doi: 10.1136/bjo.57.9.669.CrossRefGoogle Scholar
  3. 3.
    Bendall RP, Chiodini PL. New diagnostic methods for parasitic infections. Curr Opin Infect Dis. 1993;6:318–23.Google Scholar
  4. 4.
    Botero JH, Castaño A, Montoya MN, Ocampo NE, Hurtado MI, et al. A preliminary study of the prevalence of intestinal parasites in immunocompromised patients with and without gastrointestinal manifestations. Rev Inst Med Trop Sao Paulo. 2003;45:197–200. doi: 10.1590/S0036-46652003000400004.PubMedGoogle Scholar
  5. 5.
    da Silva AJ, Schwartz DA, Visvesvara GS, de Moura H, Slemenda SB, et al. Sensitive PCR diagnosis of infections by Enterocytozoon bieneusi (Microsporidia) using primers based on the region coding for small-subunit rRNA. J Clin Microbiol. 1996;34:986–7.PubMedGoogle Scholar
  6. 6.
    del Aguila C, Moura H, Soledad F, Navajas R, Lopez-Velez R, et al. In vitro culture, ultrastructure, antigenic, and molecular characterization of Encephalitozoon cuniculi isolated from urine and sputum samples from a Spanish patient with AIDS. J Clin Microbiol. 2001;39:1105–8. doi: 10.1128/JCM.39.3.1105-1108.2001.PubMedCrossRefGoogle Scholar
  7. 7.
    Delbac F, Vivares C. A PCR technique for detecting and differentiating known microsporidia in AIDS patients. J Eukaryot Microbiol. 1997;44:75S. doi: 10.1111/j.1550-7408.1997.tb05789.x.PubMedCrossRefGoogle Scholar
  8. 8.
    Franzen C, Müller A, Hartmann P, Hegener P, Schrappe M, et al. Polymerase chain reaction for diagnosis and species differentiation of microsporidia. Folia Parasitol (Praha). 1998;45:140–8.Google Scholar
  9. 9.
    Kelkar R, Sastry PSRK, Kulkarni SS, Saikia TK, Parikh PM, et al. Pulmonary microsporidial infection in a patient with CML undergoing allogeneic marrow transplant. Bone Marrow Transplant. 1997;19:179–82. doi: 10.1038/sj.bmt.1700536.PubMedCrossRefGoogle Scholar
  10. 10.
    Kokoskin E, Gyorkos TW, Camus A, Cedilotte L, Purtill T, et al. Modified technique for efficient detection of microsporidia. J Clin Microbiol. 1994;32:1074–5.PubMedGoogle Scholar
  11. 11.
    Kumar S, Ananthan S, Joyee AG. Detection of Enterocytozoon bieneusi (Microsporidia) by polymerase chain reaction (PCR) using species-specific primer in stool samples of HIV patients. Indian J Med Res. 2005;121:215–9.PubMedGoogle Scholar
  12. 12.
    Lim KG, Sellaiah SP. Biliary ascariasis and extrahepatic cholangiocarcinoma: a report of two cases. Singapore Med J. 1994;35:400–2.PubMedGoogle Scholar
  13. 13.
    Lores B, Lopez-Miragaya I, Arias C, Fenoy S, Torres J, et al. Intestinal microsporidiosis due to Enterocytozoon bieneusi in elderly human immunodeficiency virus-negative patients from Vigo, Spain. Clin Infect Dis. 2002;34:918–21. doi: 10.1086/339205.PubMedCrossRefGoogle Scholar
  14. 14.
    Menon BS, Abdullah MS, Mahamud F, Sing B. Intestinal parasites in Malaysian children with cancer. J Trop Pediatr. 1999;45:241–2. doi: 10.1093/tropej/45.4.241.PubMedCrossRefGoogle Scholar
  15. 15.
    Müller M, Bialek R, Kämper A, Fätkenheuer G, Salzberger B, et al. Detection of microsporidia in travelers with diarrhea. J Clin Microbiol. 2001;39:1630–2. doi: 10.1128/JCM.39.4.1630-1632.2001.PubMedCrossRefGoogle Scholar
  16. 16.
    Orenstein JM, Russo P, Didier ES, Bowers C, Bunin N, et al. Fatal pulmonary microsporidiosis due to Encephalitozoon cuniculi following allogeneic bone marrow transplantation for acute myelogenous leukemia. Ultrastruct Pathol. 2005;29:269–76. doi: 10.1080/01913120590951257.PubMedCrossRefGoogle Scholar
  17. 17.
    Rotterdam H, Tsang P. Gastrointestinal disease in the immunocompromised patient. Hum Pathol. 1994;25:1123–40. doi: 10.1016/0046-8177(94)90029-9.PubMedCrossRefGoogle Scholar
  18. 18.
    Smith PD, Lane HC, Gill VJ, Manischewitz JF, Quinnan GV, et al. Intestinal infections in patients with the acquired immunodeficiency syndrome (AIDS). Etiology and response to therapy. Ann Intern Med. 1988;108:328–33.PubMedGoogle Scholar
  19. 19.
    Smith HV, Rose JD. Waterborne cryptosporidiosis: current status. Parasitol Today. 1998;14:14–22. doi: 10.1016/S0169-4758(97)01150-2.PubMedCrossRefGoogle Scholar
  20. 20.
    Van Eys GJJM, Gravekamp C, Gerritsen MJ, Quint W, Cornelissen MTE, et al. Detection of leptospires in urine by polymerase chain reaction. J Clin Microbiol. 1989;27:2258–62.PubMedGoogle Scholar
  21. 21.
    van Gool T, Canning EU, Dankert J. An improved practical and sensitive technique for the detection of microsporidian spores in stool samples. Trans R Soc Trop Med Hyg. 1994;88:189–90. doi: 10.1016/0035-9203(94)90290-9.PubMedCrossRefGoogle Scholar
  22. 22.
    Velasquez JN, Carnevale S, Guarnera EA, Labbe JH, Chertcoff A, et al. Detection of the microsporidian parasite Enterocytozoon bieneusi in specimens from patients with AIDS by PCR. J Clin Microbiol. 1996;34:3230–2.PubMedGoogle Scholar
  23. 23.
    Visvesvara GS, Leitch GJ, da Silva AJ, Croppo GP, Moura H, et al. Polyclonal and monoclonal antibody and PCR-amplified small-subunit rRNA identification of a microsporidia, Encephalitozoon hellem, isolated from an AIDS patient with disseminated infection. J Clin Microbiol. 1994;32:2760–8.PubMedGoogle Scholar
  24. 24.
    Weiss LM, Zhu X, Cali A, Tanowitz HB, Wittner M. Utility of microsporidian rRNA in diagnosis and phylogeny: a review. Folia Parasitol (Praha). 1994;41:81–90.Google Scholar
  25. 25.
    Yazar S, Eser B, Yalcin S, Sahin I, Koc AN. A case of pulmonary microsporidiasis in an acute myeloblastic leukemia (AML)-M3 patient. Yonsei Med J. 2003;44:146–9.PubMedGoogle Scholar
  26. 26.
    Yoken J, Forbes B, Magure AM, Prenner JL, Carpentieri D. Microsporidial endophthalmitis in a patients with acute myelogenous leukemia. Retina. 2002;22:123–5. doi: 10.1097/00006982-200202000-00028.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc. 2009

Authors and Affiliations

  1. 1.University of MalayaKuala LumpurMalaysia

Personalised recommendations