Microsporidia are obligate intracellular pathogens identified ∼150 years ago as the cause of pébrine, an economically important infection in silkworms. There are about 220 genera and 1,700 species of microsporidia, which are classified based on their ultrastructural features, developmental cycle, host-parasite relationship, and molecular analysis. Phylogenetic analysis suggests that microsporidia are related to the fungi, being grouped with the Cryptomycota as a basal branch or sister group to the fungi. Microsporidia can be transmitted by food and water and are likely zoonotic, as they parasitize a wide range of invertebrate and vertebrate hosts. Infection in humans occurs in both immunocompetent and immunodeficient hosts, e.g., in patients with organ transplantation, patients with advanced human immunodeficiency virus (HIV) infection, and patients receiving immune modulatory therapy such as anti-tumor necrosis factor alpha antibody. Clusters of infections due to latent infection in transplanted organs have also been demonstrated. Gastrointestinal infection is the most common manifestation; however, microsporidia can infect virtually any organ system, and infection has resulted in keratitis, myositis, cholecystitis, sinusitis, and encephalitis. Both albendazole and fumagillin have efficacy for the treatment of various species of microsporidia; however, albendazole has limited efficacy for the treatment of Enterocytozoon bieneusi. In addition, immune restoration can lead to resolution of infection. While the prevalence rate of microsporidiosis in patients with AIDS has fallen in the United States, due to the widespread use of combination antiretroviral therapy (cART), infection continues to occur throughout the world and is still seen in the United States in the setting of cART if a low CD4 count persists.

Get full access to this article.

View all available purchase options and get full access to this article.


Weiss LM. 2020. Microsporidiosis, p 825–831. In Ryan ET, Hill DR, Solomon T, Aronson N, Endy TP (ed), Hunter's tropical medicine and emerging infectious diseases. Elsevier, Amsterdam, Netherlands.
James TY, Pelin A, Bonen L, Ahrendt S, Sain D, Corradi N, Stajich JE. 2013. Shared signatures of parasitism and phylogenomics unite Cryptomycota and microsporidia. Curr Biol 23:1548–1553.
Jones MD, Forn I, Gadelha C, Egan MJ, Bass D, Massana R, Richards TA. 2011. Discovery of novel intermediate forms redefines the fungal tree of life. Nature 474:200–203.
Corsaro D, Michel R, Walochnik J, Venditti D, Muller KD, Hauroder B, Wylezich C. 2016. Molecular identification of Nucleophaga terricolae sp. nov. (Rozellomycota), and new insights on the origin of the Microsporidia. Parasitol Res 115:3003–3011.
Sprague V. 1977. Systematics of the microsporidia, p 1–510. In Bulla LA, Cheng TC (ed), Comparative pathobiology, vol 2. Plenum Press, New York, NY.
Sprague V, Becnel JJ. 1998. Note on the name-author-date combination for the taxon MICROSPORIDIES Balbiani, 1882, when ranked as a phylum. J Invertebr Pathol 71:91–94.
Weber R, Deplazes P, Schwartz D. 2000. Diagnosis and clinical aspects of human microsporidiosis. Contrib Microbiol 6:166–192.
Williams BAP, Hirt RP, Lucocq JM, Embley TM. 2002. A mitochondrial remnant in the microsporidian Trachipleistophora hominis. Nature 418:865–869.
Hollister WS, Canning EU. 1987. An enzyme-linked immunosorbent assay (ELISA) for detection of antibodies to Encephalitozoon cuniculi and its use in determination of infections in man. Parasitology 94:209–219.
Curgy JJ, Vavra J, Vivares C. 1980. Presence of ribosomal RNAs with prokaryotic properties in Microsporidia, eukaryotic organisms. Biol Cell 38:49–52.
Vossbrinck CR, Woese CR. 1986. Eukaryotic ribosomes that lack a 5.8S RNA. Nature 320:287–288.
Weiss LM, Vossbrinck CR. 1999. Molecular biology, molecular phylogeny, and molecular diagnostic approaches to the microsporidia, p 129–171. In Wittner M, Weiss LM (ed), The microsporidia and microsporidiosis. ASM Press, Washington, DC.
Weiss LM, Bechnel JJ. 2014. Microsporidia: pathogens of opportunity. Wiley Blackwell, Oxford, United Kingdom.
Weiss LM. 2000. Molecular phylogeny and diagnostic approaches to microsporidia. Contrib Microbiol 6:209–235.
Katinka MD, Duprat S, Cornillot E, Metenier G, Thomarat F, Prensier G, Barbe V, Peyretaillade E, Brottier P, Wincker P, Delbac F, El Alaoui H, Peyret P, Saurin W, Gouy M, Weissenbach J, Vivares CP. 2001. Genome sequence and gene compaction of the eukaryote parasite Encephalitozoon cuniculi. Nature 414:450–453.
Nakjang S, Williams TA, Heinz E, Watson AK, Foster PG, Sendra KM, Heaps SE, Hirt RP, Martin Embley T. 2013. Reduction and expansion in microsporidian genome evolution: new insights from comparative genomics. Genome Biol Evol 5:2285–2303.
Wadi L, Reinke AW. 2020. Evolution of microsporidia: an extremely successful group of eukaryotic intracellular parasites. PLoS Pathog 16:e1008276.
Williams BA, Lee RC, Becnel JJ, Weiss LM, Fast NM, Keeling PJ. 2008. Genome sequence surveys of Brachiola algerae and Edhazardia aedis reveal microsporidia with low gene densities. BMC Genomics 9:200.
Aurrecoechea C, Barreto A, Brestelli J, Brunk BP, Caler EV, Fischer S, Gajria B, Gao X, Gingle A, Grant G, Harb OS, Heiges M, Iodice J, Kissinger JC, Kraemer ET, Li W, Nayak V, Pennington C, Pinney DF, Pitts B, Roos DS, Srinivasamoorthy G, Stoeckert CJ, Jr, Treatman C, Wang H. 2011. AmoebaDB and MicrosporidiaDB: functional genomic resources for Amoebozoa and Microsporidia species. Nucleic Acids Res 39:D612–D619.
Pombert JF, Xu J, Smith DR, Heiman D, Young S, Cuomo CA, Weiss LM, Keeling PJ. 2013. Complete genome sequences from three genetically distinct strains reveal high intraspecies genetic diversity in the microsporidian Encephalitozoon cuniculi. Eukaryot Cell 12:503–511.
Pombert JF, Selman M, Burki F, Bardell FT, Farinelli L, Solter LF, Whitman DW, Weiss LM, Corradi N, Keeling PJ. 2012. Gain and loss of multiple functionally related, horizontally transferred genes in the reduced genomes of two microsporidian parasites. Proc Natl Acad Sci U S A 109:12638–12643.
Corradi N, Pombert JF, Farinelli L, Didier ES, Keeling PJ. 2010. The complete sequence of the smallest known nuclear genome from the microsporidian Encephalitozoon intestinalis. Nat Commun 1:77.
Keeling PJ, Corradi N, Morrison HG, Haag KL, Ebert D, Weiss LM, Akiyoshi DE, Tzipori S. 2010. The reduced genome of the parasitic microsporidian Enterocytozoon bieneusi lacks genes for core carbon metabolism. Genome Biol Evol 2:304–309.
Akiyoshi DE, Morrison HG, Lei S, Feng X, Zhang Q, Corradi N, Mayanja H, Tumwine JK, Keeling PJ, Weiss LM, Tzipori S. 2009. Genomic survey of the non-cultivatable opportunistic human pathogen, Enterocytozoon bieneusi. PLoS Pathog 5:e1000261.
Weiss LM, Vossbrinck CR. 1998. Microsporidiosis: molecular and diagnostic aspects. Adv Parasitol 40:351–395.
Matos O, Lobo ML, Xiao L. 2012. Epidemiology of Enterocytozoon bieneusi infection in humans. J Parasitol Res 2012:981424–981424.
Tuzet O, Maurand J, Fize JA, Michel R, Fenwick B. 1971. Proposition d'un nouveau cadre systematique pour les genres de Microsporidies. C R Hebd Seances Acad Sci 272:1268–1271.
Larsson JIR. 1988. Identification of microsporidian genera—a guide with comments on the taxonomy. Arch Protistenkd 136:1–37.
Issi IV. 1986. Microsporidia as a phylum of parasitic protozoa. Protozoology 10:6–135. (In Russian.)
Weiser J. 1977. A proposal of the basis for microsporidian taxonomy. Proc Int Congr Protozool 5:267.
Sprague V, Becnel JJ, Hazard EI. 1992. Taxonomy of phylum Microspora. Crit Rev Microbiol 18:285–395.
Franzen C. 2008. Microsporidia: a review of 150 years of research. Open Parasitol J 2:1–34.
Weber R, Bryan RT, Schwartz DA, Owen RL. 1994. Human microsporidial infections. Clin Microbiol Rev 7:426–461.
Matsubayashi H, Koide T, Mikata T, Hagiwara S. 1959. A case of Encephalitozoon-like body infection in man. Arch Pathol Lab Med 67:181–185.
Steinhaus EA, Martignoni ME. 1970. Abridged glossary of terms used in invertebrate pathology, 2nd ed. USDA, Pacific Northwest Forest and Range Experiment Station, Portland, OR.
Fine PE. 1975. Vectors and vertical transmission: an epidemiologic perspective. Ann N Y Acad Sci 266:173–194.
Pavie J, Menotti J, Porcher R, Donay JL, Gallien S, Sarfati C, Derouin F, Molina JM. 2012. Prevalence of opportunistic intestinal parasitic infections among HIV-infected patients with low CD4 cells counts in France in the combination antiretroviral therapy era. Int J Infect Dis 16:e677-9.
Logan C, Beadsworth MB, Beeching NJ. 2016. HIV and diarrhoea: what is new? Curr Opin Infect Dis 29:486–494.
Greigert V, Pfaff AW, Abou-Bacar A, Candolfi E, Brunet J. 2018. Intestinal microsporidiosis in Strasbourg from 2014 to 2016: emergence of an Enterocytozoon bieneusi genotype of Asian origin. Emerg Microbes Infect 7:97.
Wang L, Zhang H, Zhao X, Zhang L, Zhang G, Guo M, Liu L, Feng Y, Xiao L. 2013. Zoonotic Cryptosporidium species and Enterocytozoon bieneusi genotypes in HIV-positive patients on antiretroviral therapy. J Clin Microbiol 51:557–563.
Silveira H, Canning EU. 1995. Vittaforma corneae n. comb. for the human microsporidium Nosema corneum Shadduck, Meccoli, Davis & Font, 1990, based on its ultrastructure in the liver of experimentally infected athymic mice. J Eukaryot Microbiol 42:158–165.
Call A, Takvorian PM, Lewin S, Rendel M, Sian CS, Wittner M, Tanowitz HB, Keohane E, Weiss LM. 1998. Brachiola vesicularum, n. g., n. sp., a new microsporidium associated with AIDS and myositis. J Eukaryot Microbiol 45:240–251.
Franzen C, Nassonova ES, Scholmerich J, Issi IV. 2006. Transfer of the members of the genus Brachiola (microsporidia) to the genus Anncaliia based on ultrastructural and molecular data. J Eukaryot Microbiol 53:26–35.
Desportes I, Charpentier YL, Galian A, Bernard F, Cochand-Priollet B, Lavergne A, Ravisse P, Modigliani R. 1985. Occurrence of a new microsporidian: Enterocytozoon bieneusi n. g., n. sp., in the enterocytes of a human patient with AIDS. J Protozool 32:250–245.
Cali A, Kotler DP, Orenstein JM. 1993. Septata intestinalis n. g., n. sp., an intestinal microsporidian associated with chronic diarrhea and dissemination in AIDS patients. J Eukaryot Microbiol 40:101–112.
Hartskeerl RA, Van Gool T, Schuitema AR, Didier ES, Terpstra WJ. 1995. Genetic and immunological characterization of the microsporidian Septata intestinalis Cali, Kotler and Orenstein, 1993: reclassification to Encephalitozoon intestinalis. Parasitology 110:277–285.
Field AS, Marriott DJ, Milliken ST, Brew BJ, Canning EU, Kench JG, Darveniza P, Harkness JL. 1996. Myositis associated with a newly described microsporidian, Trachipleistophora hominis, in a patient with AIDS. J Clin Microbiol 34:2803–2811.
Yachnis AT, Berg J, Martinez-Salazar A, Bender BS, Diaz L, Rojiani AM, Eskin TA, Orenstein JM. 1996. Disseminated microsporidiosis especially infecting the brain, heart, and kidneys. Report of a newly recognized pansporoblastic species in two symptomatic AIDS patients. Am J Clin Pathol 106:535–543.
Meissner EG, Bennett JE, Qvarnstrom Y, da Silva A, Chu EY, Tsokos M, Gea-Banacloche J. 2012. Disseminated microsporidiosis in an immunosuppressed patient. Emerg Infect Dis 18:1155–1158.
Choudhary MM, Metcalfe MG, Arrambide K, Bern C, Visvesvara GS, Pieniazek NJ, Bandea RD, Deleon-Carnes M, Adem P, Choudhary MM, Zaki SR, Saeed MU. 2011. Tubulinosema sp. microsporidian myositis in immunosuppressed patient. Emerg Infect Dis 17:1727–1730.
Suankratay C, Thiansukhon E, Nilaratanakul V, Putaporntip C, Jongwutiwes S. 2012. Disseminated infection caused by novel species of Microsporidium, Thailand. Emerg Infect Dis 18:302–304.
Fayer R, Santin-Duran M. 2014. Epidemiology of microsporidia in human infections, p 135–164. In Weiss LM, Becnel JJ (ed), Microsporidia: pathogens of opportunity. Wiley Blackwell, Oxford, United Kingdom.
Kent ML, Elliott DG, Groff JM, Hedrick RP. 1989. Loma salmonae (Protozoa: Microspora) infections in seawater reared coho salmon Oncorhynchus kisutch. Aquaculture 80:211–222.
Vavra J. 1976. Structure of the microsporidia, p 1–85. In Bulla LA, Cheng TC (ed), Comparative pathobiology, vol 1. Plenum Press, New York, NY.
Olson RE, Tiekotter KL, Reno PW. 1994. Nadelspora canceri n. g., n. sp., an unusual microsporidian parasite of the Dungeness crab, Cancer magister. J Eukaryot Microbiol 41:349–359.
Canning EU, Lom J, Dykova I. 1987. The microsporidia of vertebrates. J Basic Microbiol 27:252–252.
Thélohan P. 1894. Sur la presence d’une capsule a filament dans les spores des microsporidies. C R Hebd Seances Acad Sci 118:1425–1427.
Keeling PJ, Fast NM. 2002. Microsporidia: biology and evolution of highly reduced intracellular parasites. Annu Rev Microbiol 56:93–116.
Jaroenlak P, Cammer M, Davydov A, Sall J, Usmani M, Liang F-X, Ekiert DC, Bhabha G. 2020. 3-Dimensional organization and dynamics of the microsporidian polar tube invasion machinery. PLoS Pathog 16:e1008738.
Han B, Weiss LM. 2017. Microsporidia: obligate intracellular pathogens within the fungal kingdom. Microbiol Spec 5:10.1128/microbiolspec.FUNK-0018-2016.
Bigliardi E, Sacchi L. 2001. Cell biology and invasion of the microsporidia. Microbes Infect 3:373–379.
Southern TR, Jolly CE, Lester ME, Hayman JR. 2007. EnP1, a microsporidian spore wall protein that enables spores to adhere to and infect host cells in vitro. Eukaryot Cell 6:1354–1362.
Bigliardi E. 2001. Microsporidia, enigmatic parasites. Ital J Zool 68:263–271.
Kudo R. 1920. On the structure of some microsporidian spores. J Parasitol 6:178–182.
Lom J. 1972. On the structure of the extruded microsporidian polar filament. Z Parasitenkd 38:200–213.
Xu Y, Weiss LM. 2005. The microsporidian polar tube: a highly specialised invasion organelle. Int J Parasitol 35:941–953.
Delbac F, Polonais V. 2008. The microsporidian polar tube and its role in invasion. Subcell Biochem 47:208–220.
Keohane E, Weiss LM. 1999. The structure, function, and composition of the microsporidian polar tube, p 196–224. In Wittner M, Weiss LM (ed), The microsporidia and microsporidiosis. ASM Press, Washington, DC.
Undeen AH, Frixione E. 1990. The role of osmotic pressure in the germination of Nosema algerae spores. J Protozool 37:561–567.
Undeen AH, Vander Meer RK. 1999. Microsporidian intrasporal sugars and their role in germination. J Invertebr Pathol 73:294–302.
He Q, Leitch GJ, Visvesvara GS, Wallace S. 1996. Effects of nifedipine, metronidazole, and nitric oxide donors on spore germination and cell culture infection of the microsporidia Encephalitozoon hellem and Encephalitozoon intestinalis. Antimicrob Agents Chemother 40:179–185.
Leitch GJ, He Q, Wallace S, Visvesvara GS. 1993. Inhibition of the spore polar filament extrusion of the microsporidium, Encephalitozoon hellem, isolated from an AIDS patient. J Eukaryot Microbiol 40:711–717.
Andreadis TG. 1985. Experimental transmission of a microsporidian pathogen from mosquitoes to an alternate copepod host. Proc Natl Acad Sci U S A 82:5574–5577.
Sweeney AW, Hazard EI, Graham MF. 1985. Intermediate host for an Amblyospora sp. (microspora) infecting the mosquito, Culex annulirostris. J Invertebr Pathol 46:98–102.
Cali A, Becnel J, Takvorian P. 2017. Microsporidia, p 1559–1618. In Archibald J, Simpson A, Slamovits C (ed), Handbook of the protists. Springer, Cham, Switzerland.
Cali A, Neafie RC, Takvorian PM. 2011. Microsporidiosis, p 61–76. In Meyers WM, Firpo A, Wear DJ (ed), Topics on the pathology of protozoan and invasive arthropod diseases, 3rd ed. Armed Forces Institute of Pathology, Washington, DC.
Weidner E. 1975. Interactions between Encephalitozoon cuniculi and macrophages. Parasitophorous vacuole growth and the absence of lysosomal fusion. Z Parasitenkd 47:1–9.
Cali A, Owen RL. 1988. Microsporidiosis. In Balows A, Hausler WJ, Ohashi M, Turano A, Lennete EH (ed), Laboratory diagnosis of infectious diseases. Springer, New York, NY.
Overstreet RM, Weidner E. 1974. Differentiation of microsporidian spore-tails in Inodosporus spraguei Gen. et Sp. N. Z Parasitenkd 44:169–186.
Weidner E. 1976. The microsporidian spore invasion tube. The ultrastructure, isolation, and characterization of the protein comprising the tube. J Cell Biol 71:23–34.
Docker MF, Kent ML, Hervio DML, Khattra JS, Weiss LM, Cali A, Devlin RH. 1997. Ribosomal DNA sequence of Nucleospora salmonis Hedrick, Groff and Baxa, 1991 (Microsporea: Enterocytozoonidae): implications for phylogeny and nomenclature. J Eukaryot Microbiol 44:55–60.
Stentiford G, Bateman K, Longshaw M, Feist S. 2007. Enterospora canceri n. gen., n. sp., intranuclear within the hepatopancreatocytes of the European edible crab Cancer pagurus. Dis Aquat Org 75:61–72.
Freeman MA, Sommerville C. 2009. Desmozoon lepeophtherii n. gen., n. sp., (Microsporidia: Enterocytozoonidae) infecting the salmon louse Lepeophtheirus salmonis (Copepoda: Caligidae). Parasit Vectors 2:58–58.
Palenzuela O, Redondo MJ, Cali A, Takvorian PM, Alonso-Naveiro M, Alvarez-Pellitero P, Sitja-Bobadilla A. 2014. A new intranuclear microsporidium, Enterospora nucleophila n. sp., causing an emaciative syndrome in a piscine host (Sparus aurata), prompts the redescription of the family Enterocytozoonidae. Int J Parasitol 44:189–203.
Fries I, Paxton RJ, Tengö J, Slemenda SB, da Silva AJ, Pieniazek NJ. 1999. Morphological and molecular characterization of Antonospora scoticae n. gen., n. sp. (Protozoa, Microsporidia) a parasite of the communal bee, Andrena scotica Perkins, 1916 (Hymenoptera, Andrenidae). Eur J Protist 35:183–193.
Bohne W, Ferguson DJ, Kohler K, Gross U. 2000. Developmental expression of a tandemly repeated, glycine-and serine-rich spore wall protein in the microsporidian pathogen Encephalitozoon cuniculi. Infect Immun 68:2268–2275.
Yang D, Pan L, Chen Z, Du H, Luo B, Luo J, Pan G. 2018. The roles of microsporidia spore wall proteins in the spore wall formation and polar tube anchorage to spore wall during development and infection processes. Exp Parasitol 187:93–100.
Beznoussenko GV, Dolgikh VV, Seliverstova EV, Semenov PB, Tokarev YS, Trucco A, Micaroni M, Di Giandomenico D, Auinger P, Senderskiy IV, Skarlato SO, Snigirevskaya ES, Komissarchik YY, Pavelka M, De Matteis MA, Luini A, Sokolova YY, Mironov AA. 2007. Analogs of the Golgi complex in microsporidia: structure and avesicular mechanisms of function. J Cell Sci 120:1288–1298.
Jaronski ST. 1984. Microsporida in cell culture. Adv Cell Culture 3:183–229.
Visvesvara GS. 2002. In vitro cultivation of microsporidia of clinical importance. Clin Microbiol Rev 15:401–413.
Trager W. 1937. The hatching of spores of Nosema bombycis Nägeli and the partial development of the organism in tissue cultures. J Parasitol 23:226–227.
Juarez S, Putaporntip C, Jongwutiwes S, Ichinose A, Yanagi T, Kanbara H. 2005. In vitro cultivation and electron microscopy characterization of Trachipleistophora anthropophthera isolated from the cornea of an AIDS patient. J Eukaryot Microbiol 52:179–190.
Shadduck JA, Meccoli RA, Davis R, Font RL. 1990. Isolation of a microsporidian from a human patient. J Infect Dis 162:773–776.
De Groote MA, Visvesvara G, Wilson ML, Pieniazek NJ, Slemenda SB, daSilva AJ, Leitch GJ, Bryan RT, Reves R. 1995. Polymerase chain reaction and culture confirmation of disseminated Encephalitozoon cuniculi in a patient with AIDS: successful therapy with albendazole. J Infect Dis 171:1375–1378.
del Aguila C, Moura H, Fenoy S, Navajas R, Lopez-Velez R, Li L, Xiao L, Leitch GJ, da Silva A, Pieniazek NJ, Lal AA, Visvesvara GS. 2001. 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 39:1105–1108.
Hollister WS, Canning EU, Colbourn NI, Aarons EJ. 1995. Encephalitozoon cuniculi isolated from the urine of an AIDS patient, which differs from canine and murine isolates. J Eukaryot Microbiol 42:367–372.
Deplazes P, Mathis A, Baumgartner R, Tanner I, Weber R. 1996. Immunologic and molecular characteristics of encephalitozoon-like microsporidia isolated from humans and rabbits indicate that Encephalitozoon cuniculi is a zoonotic parasite. Clin Infect Dis 22:557–559.
Mathis A, Michel M, Kuster H, Müller C, Weber R, Deplazes P. 1997. Two Encephalitozoon cuniculi strains of human origin are infectious to rabbits. Parasitology 114:29–35.
Weber R, Deplazes P, Flepp M, Mathis A, Baumann R, Sauer B, Kuster H, Luthy R. 1997. Cerebral microsporidiosis due to Encephalitozoon cuniculi in a patient with human immunodeficiency virus infection [see comments. N Engl J Med 336:474–478.
Deplazes P, Mathis A, van Saanen M, Iten A, Keller R, Tanner I, Glauser MP, Weber R, Canning EU. 1998. Dual microsporidial infection due to Vittaforma corneae and Encephalitozoon hellem in a patient with AIDS. Clin Infect Dis 27:1521–1524.
Rossi P, Rosa GL, Ludovisi A, Tamburrini A, Morales MAG, Pozio E. 1998. Identification of a human isolate of Encephalitozoon cuniculi type I from Italy. Int J Parasitol 28:1361–1366.
Visvesvara GS, Leitch GJ, Wallace S, Seaba C, Erdman D, Ewing EP, Jr. 1996. Adenovirus masquerading as microsporidia. J Parasitol 82:316–319.
Didier ES, Didier PJ, Friedberg DN, Stenson SM, Orenstein JM, Yee RW, Tio FO, Davis RM, Vossbrinck C, Millichamp N. 1991. Isolation and characterization of a new human microsporidian, Encephalitozoon hellem (n. sp.), from three AIDS patients with keratoconjunctivitis. J Infect Dis 163:617–621.
Didier ES, Rogers LB, Orenstein JM, Baker MD, Vossbrinck CR, Van Gool T, Hartskeerl R, Soave R, Beaudet LM. 1996. Characterization of Encephalitozoon (Septata) intestinalis isolates cultured from nasal mucosa and bronchoalveolar lavage fluids of two AIDS patients. J Eukaryot Microbiol 43:34–43.
Didier ES, Visvesvara GS, Baker MD, Rogers LB, Bertucci DC, Groote MAD, Vossbrinck CR. 1996. A microsporidian isolated from an AIDS patient corresponds to Encephalitozoon cuniculi III, originally isolated from domestic dogs. J Clin Microbiol 34:2835–2837.
Visvesvara GS, Leitch GJ, Moura H, Wallace S, Weber R, Bryan RT. 1991. Culture, electron microscopy, and immunoblot studies on a microsporidian parasite isolated from the urine of a patient with AIDS. J Protozool 38:105S–111S.
Hollister WS, Canning EU, Colbourn NI, Curry A, Lacey CJN. 1993. Characterization of Encephalitozoon hellem (Microspora) isolated from the nasal mucosa of a patient with AIDS. Parasitology 107:351–358.
Ws H, Eu C, Ni C. 1993. A species of Encephalitozoon isolated from an AIDS patient: criteria for species differentiation. Folia Parasitol 40:293–295.
Scaglia M, Sacchi L, Gatti S, Bernuzzi AM, Polver PP, Piacentini I, Concia E, Croppo GP, da Silva AJ, Pieniazek NJ. 1994. Isolation and identification of Encephalitozoon hellem from an Italian AIDS patient with disseminated microsporidiosis. APMIS 102:817–827.
Scaglia M, Sacchi L, Croppo GP, da Silva A, Gatti S, Corona S, Orani A, Bernuzzi AM, Pieniazek NJ, Slemenda SB, Wallace S, Visvesvara GS. 1997. Pulmonary microsporidiosis due to Encephalitozoon hellem in a patient with AIDS. J Infection 34:119–126.
Scaglia M, Gatti S, Sacchi L, Corona S, Chichino G, Bernuzzi AM, Barbarini G, Croppo GP, Silva AJD, Pieniazek NJ, Visvesvara GS. 1998. Asymptomatic respiratory tract microsporidiosis due to Encephalitozoon hellem in three patients with AIDS. Clin Infect Dis 26:174–176.
Visvesvara GS, Leitch GJ, da Silva AJ, Croppo GP, Moura H, Wallace S, Slemenda SB, Schwartz DA, Moss D, Bryan RT. 1994. Polyclonal and monoclonal antibody and PCR-amplified small-subunit rRNA identification of a microsporidian, Encephalitozoon hellem, isolated from an AIDS patient with disseminated infection. J Clin Microbiol 32:2760–2768.
Visvesvara GS, da Silva AJ, Croppo GP, Pieniazek NJ, Leitch GJ, Ferguson D, de Moura H, Wallace S, Slemenda SB, Tyrrell I. 1995. In vitro culture and serologic and molecular identification of Septata intestinalis isolated from urine of a patient with AIDS. J Clin Microbiol 33:930–936.
Gatti S, Sacchi L, Novati S, Cornona S, Bernuzzp AM, Moura H, Pieniazek NJ, Visvervara GS, Scaglia M. 1997. Extraintestinal microsporidiosis in AIDS patients: clinical features and advanced protocols for diagnosis and characterization of the isolates. J Eukaryot Microbiol 44:79S.
Peman J, Bornay-Llinares FJ, Acosta BA, López-Aldeguer J, Figueras M, Peset V, Gobernado M, Meseguer Y, Visvesvara G. 1997. First report of a case of Encephalitozoon spp. microsporidiosis in a Spanish AIDS patient. Rev Ibér Parasitol 57:131–134.
van Gool T, Canning EU, Gilis H, van den Bergh Weerman MA, Eeftinck Schattenkerk JK, Dankert J. 1994. Septata intestinalis frequently isolated from stool of AIDS patients with a new cultivation method. Parasitology 109:281–289.
Doultree JC, Maerz AL, Ryan NJ, Baird RW, Wright E, Crowe SM, Marshall JA. 1995. In vitro growth of the microsporidian Septata intestinalis from an AIDS patient with disseminated illness. J Clin Microbiol 33:463–470.
Molina J-M, Oksenhendler E, Beauvais B, Sarfati C, Jaccard A, Derouin F, Modaï J. 1995. Disseminated microsporidiosis due to Septata intestinalis in patients with AIDS: clinical features and response to albendazole therapy. J Infect Dis 171:245–249.
Visvesvara GS, Leitch GJ, Pieniazek NJ, Silva AJD, Wallace S, Slemenda SB, Weber R, Schwartz DA, Gorelkin L, Wilcox CM, Bryan RT. 1995. Short-term in vitro culture and molecular analysis of the microsporidian, Enterocytozoon bieneusi. J Eukaryot Microbiol 42:506–510.
Croppo GP, Croppo GP, Moura H, Da Silva AJ, Leitch GJ, Moss DM, Wallace S, Slemenda SB, Pieniazek NJ, Visvesvara GS. 1998. Ultrastructure, immunofluorescence, Western blot, and PCR analysis of eight isolates of Encephalitozoon (Septata) intestinalis established in culture from sputum and urine samples and duodenal aspirates of five patients with AIDS. J Clin Microbiol 36:1201–1208.
Croppo GP, Visvesvara GS, Leitch GJ, Wallace S, Schwartz DA. 1998. Identification of the microsporidian Encephalitozoon hellem using immunoglobulin G monoclonal antibodies. Arch Pathol Lab Med 122:182–186.
Desportes-Livage I, Chilmonczyk S, Hedrick R, Ombrouck C, Monge D, Maiga I, Gentilini M. 1996. Comparative development of two microsporidian species: Enterocytozoon bieneusi and Enterocytozoon salmonis, reported in AIDS patients and salmonid fish, respectively. J Eukaryot Microbiol 43:49–60.
Izquierdo F, Castro Hermida JA, Fenoy S, Mezo M, González-Warleta M, del Aguila C. 2011. Detection of microsporidia in drinking water, wastewater and recreational rivers. Water Res 45:4837–4843.
Jiang W, Roellig DM, Li N, Wang L, Guo Y, Feng Y, Xiao L. 2020. Contribution of hospitals to the occurrence of enteric protists in urban wastewater. Parasitol Res 119:3033–3040.
Dowd SE, Gerba CP, Pepper IL. 1998. Confirmation of the human pathogenic microsporidia Enterocytozoon bieneusi, Encephalitozoon intestinalis, and Vittaforma corneae in water. Appl Environ Microbiol 64:3332–3335.
Dowd SE, John D, Eliopolus J, Gerba CP, Naranjo J, Klein R, Lopez B, de Mejia M, Mendoza CE, Pepper IL. 2003. Confirmed detection of Cyclospora cayetanesis, Encephalitozoon intestinalis and Cryptosporidium parvum in water used for drinking. J Water Health 1:117–123.
Bryan RT, Schwartz DA. 1999. Epidemiology of microsporidiosis, p 502–516. In Wittner M, Weiss LM (ed), The microsporidia and microsporidiosis. ASM Press, Washington, DC.
Kotler DP, Orenstein JM. 1998. Clinical syndromes associated with microsporidiosis. Adv Parasitol 40:321–349.
Torres CM. 1927. A new disease parasite of man, Encephalitozoon chagasi, found in muscle and nervous tissue. C R Seances Soc Biol 97:1798–1799.
Wolf A. 1937. Granulomatous encephalomyelits due to an encephalitozoon (encephalitozoic encephalomyelitis). A new protozoan disease of man. Bull Neurol Inst NY 6:306–371.
Hollister W, Canning E, Willcox A. 1991. Evidence for widespread occurrence of antibodies to Encephalitozoon cuniculi (Microspora) in man provided by ELISA and other serological tests. Parasitology 102:33–43.
Bergquist R, Morfeldt-Mansson L, Pehrson PO, Petrini B, Wasserman J. 1984. Antibody against Encephalitozoon cuniculi in Swedish homosexual men. Scand J Infect Dis 16:389–391.
Didier ES, Stovall ME, Green LC, Brindley PJ, Sestak K, Didier PJ. 2004. Epidemiology of microsporidiosis: sources and modes of transmission. Vet Parasitol 126:145–166.
Singh M, Kane GJ, Mackinlay L, Quaki I, Yap EH, Ho BC, Ho LC, Lim KC. 1982. Detection of antibodies to Nosema cuniculi (Protozoa: Microscoporidia) in human and animal sera by the indirect fluorescent antibody technique. Southeast Asian J Trop Med Public Health 13:110–113.
WHO Parasitic Diseases Surveillance. 1983. Antibody to Encephalitozoon cuniculi in man. WHO Wkly Epidemiol Rec 58:30–32.
van Gool T, Vetter JC, Weinmayr B, Van Dam A, Derouin F, Dankert J. 1997. High seroprevalence of Encephalitozoon species in immunocompetent subjects. J Infect Dis 175:1020–1024.
Pospisilova Z, Ditrich O, Stankova M, Kodym P. 1997. Parasitic opportunistic infections in Czech HIV-infected patients—a prospective study. Cent Eur J Public Health 5:208–213.
Cislakova L, Prokopcakova H, Stef'kovic M, Halanova M. 1997. Encephalitozoon cuniculi—clinical and epidemiologic significance. Results of a preliminary serologic study in humans. Epidemiol Mikrobiol Imunol 46:30–33. (In Slovak.)
Wang ZD, Liu Q, Liu HH, Li S, Zhang L, Zhao YK, Zhu XQ. 2018. Prevalence of Cryptosporidium, Microsporidia and Isospora infection in HIV-infected people: a global systematic review and meta-analysis. Parasit Vectors 11:28.
Didier ES. 2005. Microsporidiosis: an emerging and opportunistic infection in humans and animals. Acta Trop 94:61–76.
Didier ES, Weiss LM. 2006. Microsporidiosis: current status. Curr Opin Infect Dis 19:485–492.
Chacin-Bonilla L, Panunzio AP, Monsalve-Castillo FM, Parra-Cepeda IE, Martinez R. 2006. Microsporidiosis in Venezuela: prevalence of intestinal microsporidiosis and its contribution to diarrhea in a group of human immunodeficiency virus-infected patients from Zulia State. Am J Trop Med Hyg 74:482–486.
Lobo ML, Xiao L, Antunes F, Matos O. 2012. Microsporidia as emerging pathogens and the implication for public health: a 10-year study on HIV-positive and -negative patients. Int J Parasitol 42:197–205.
Velasquez JN, di Risio C, Etchart C, Chertcoff AV, Astudillo OG, Carnevale S. 2019. Multimethodological approach to gastrointestinal microsporidiosis in HIV-infected patients. Acta Parasitol 64:658–669.
Huibers MHW, Moons P, Maseko N, Gushu MB, Iwajomo OH, Heyderman RS, Boele van Hensbroek M, Brienen EA, van Lieshout L, Calis JCJ. 2018. Multiplex real-time PCR detection of intestinal protozoa in HIV-infected children in Malawi: Enterocytozoon bieneusi is common and associated with gastrointestinal complaints and may delay BMI (nutritional status) recovery. Pediatr Infect Dis J 37:910–915.
Liu H, Jiang Z, Yuan Z, Yin J, Wang Z, Yu B, Zhou D, Shen Y, Cao J. 2017. Infection by and genotype characteristics of Enterocytozoon bieneusi in HIV/AIDS patients from Guangxi Zhuang autonomous region, China. BMC Infect Dis 17:684.
Nsagha DS, Njunda AL, Assob NJC, Ayima CW, Tanue EA, Kibu OD, Kwenti TE. 2015. Intestinal parasitic infections in relation to CD4(+) T cell counts and diarrhea in HIV/AIDS patients with or without antiretroviral therapy in Cameroon. BMC Infect Dis 16:9.
Lores B, López-Miragaya I, Arias C, Fenoy S, Torres J, del Aguila C. 2002. Intestinal microsporidiosis due to Enterocytozoon bieneusi in elderly human immunodeficiency virus-negative patients from Vigo, Spain. Clin Infect Dis 34:918–921.
Aoun K, Barbouche R, Bouratbine A, Béjaoui M, Dellagi K, Ben Ismail R. 1997. Intestinal microsporidia infections in children with primary immunologic deficiencies. Parasite 4:386–387. (In French.)
Shahrul Anuar T, M Al-Mekhlafi H, Md Salleh F, Moktar N. 2013. New insights of microsporidial infection among asymptomatic aboriginal population in Malaysia. PLoS One 8:e71870.
Mumcuoglu I, Cetin F, Dogruman Al F, Oguz I, Aksu N. 2016. Prevalence of microsporidia in healthy individuals and immunocompetent patients with acute and chronic diarrhea. Infect Dis 48:133–137.
Anuar TS, Bakar NH, Al-Mekhlafi HM, Moktar N, Osman E. 2016. Prevalence and risk factors for asymptomatic intestinal microsporidiosis among aboriginal school children in Pahang, Malaysia. Southeast Asian J Trop Med Public Health 47:441–449.
Wanke CA, DeGirolami P, Federman M. 1996. Enterocytozoon bieneusi infection and diarrheal disease in patients who were not infected with human immunodeficiency virus: case report and review. Clin Infect Dis 23:816–818.
Wichro E, Hoelzl D, Krause R, Bertha G, Reinthaler F, Wenisch C. 2005. Microsporidiosis in travel-associated chronic diarrhea in immune-competent patients. Am J Trop Med Hyg 73:285–287.
Raynaud L, Delbac F, Broussolle V, Rabodonirina M, Girault V, Wallon M, Cozon G, Vivares CP, Peyron F. 1998. Identification of Encephalitozoon intestinalis in travelers with chronic diarrhea by specific PCR amplification. J Clin Microbiol 36:37–40.
Cotte L, Rabodonirina M, Chapuis F, Bailly F, Bissuel F, Raynal C, Gelas P, Persat F, Piens MA, Trepo C. 1999. Waterborne outbreak of intestinal microsporidiosis in persons with and without human immunodeficiency virus infection. J Infect Dis 180:2003–2008.
Sak B, Kvac M, Kucerova Z, Kvetonova D, Sakova K. 2011. Latent microsporidial infection in immunocompetent individuals—a longitudinal study. PLoS Negl Trop Dis 5:e1162.
Das S, Sharma S, Sahu SK, Nayak SS, Kar S. 2012. Diagnosis, clinical features and treatment outcome of microsporidial keratoconjunctivitis. Br J Ophthalmol 96:793–795.
Loh RS, Chan CM, Ti SE, Lim L, Chan KS, Tan DT. 2009. Emerging prevalence of microsporidial keratitis in Singapore: epidemiology, clinical features, and management. Ophthalmology 116:2348–2353.
Sharma S, Das S, Joseph J, Vemuganti GK, Murthy S. 2011. Microsporidial keratitis: need for increased awareness. Surv Ophthalmol 56:1–22.
Sak B, Brady D, Pelikánová M, Květoňová D, Rost M, Kostka M, Tolarová V, Hůzová Z, Kváč M. 2011. Unapparent microsporidial infection among immunocompetent humans in the Czech Republic. J Clin Microbiol 49:1064–1070.
Sarfati C, Liguory O, Derouin F. 2001. Microsporidiosis. Presse Med 30:143–147. (In French.)
Hennequin C, Pialoux G, Bouree P, Dupont B. 1992. Microsporidiosis and acquired immunodeficiency syndrome (AIDS). Med Mal Infect 22:487–492.
Halánová M, Valenčáková A, Jarčuška P, Halán M, Danišová O, Babinská I, Dedinská K, Čisláková L. 2019. Screening of opportunistic Encephalitozoon intestinalis and Enterocytozoon bieneusi in immunocompromised patients in Slovakia. Cent Eur J Pub Health 27:330–334.
Hamamcı B, Çetinkaya Ü, Berk V, Kaynar L, Kuk S, Yazar S. 2015. Prevalence of Encephalitozoon intestinalis and Enterocytozoon bieneusi in cancer patients under chemotherapy. Mikrobiyol Bul 49:105–113.(In Turkish).
Chandramathi S, Suresh K, Anita ZB, Kuppusamy UR. 2012. Infections of Blastocystis hominis and microsporidia in cancer patients: are they opportunistic? Trans R Soc Trop Med Hyg 106:267–269.
Lono AR, Kumar S, Chye TT. 2008. Incidence of microsporidia in cancer patients. J Gastrointest Cancer 39:124–129.
Sing A, Tybus K, Heesemann J, Mathis A. 2001. Molecular diagnosis of an Enterocytozoon bieneusi human genotype C infection in a moderately immunosuppressed human immunodeficiency virus seronegative liver-transplant recipient with severe chronic diarrhea. J Clin Microbiol 39:2371–2372.
Mohindra AR, Lee MW, Visvesvara G, Moura H, Parasuraman R, Leitch GJ, Xiao L, Yee J, del Busto R. 2002. Disseminated microsporidiosis in a renal transplant recipient. Transpl Infect Dis 4:102–107.
Nagpal A, Pritt BS, Lorenz EC, Amer H, Nasr SH, Cornell LD, Iqbal S, Wilhelm MP. 2013. Disseminated microsporidiosis in a renal transplant recipient: case report and review of the literature. Transpl Infect Dis 15:526–532.
George B, Coates T, Mcdonald S, Russ G, Cherian S, Nolan J, Brealey J. 2012. Disseminated microsporidiosis with Encephalitozoon species in a renal transplant recipient. Nephrology 17:5–8.
Doshi N, Thet Z, Han T, Martin J. 2019. A case of intestinal microsporidiosis in a renal transplant recipient. J Med Cases 10:229–233.
Brown M, Longano A, Dendle C, Polkinghorne KR, Kanellis J. 2018. Confirmed microsporidial graft infection in a HIV-negative renal transplant recipient: a case report and review of the literature. Transpl Infect Dis 20:e12888.
Kicia M, Wesolowska M, Kopacz Z, Jakuszko K, Sak B, Květonová D, Krajewska M, Kváč M. 2016. Prevalence and molecular characteristics of urinary and intestinal microsporidia infections in renal transplant recipients. Clin Microbiol Infect 22:462.e5-9.
Shah S, Jacob SS, Mani R, Parameswaran A, Kumar S, Annigeria RA, Mahesh R, Uppluluri R. 2020. Renal microsporidiosis in pediatric bone marrow transplant recipients: a case series. Turk Patoloji Derg 36:68–72.
Rabodonirina M, Bertocchi M, Desportes-Livage I, Cotte L, Levrey H, Piens MA, Monneret G, Celard M, Mornex JF, Mojon M. 1996. Enterocytozoon bieneusi as a cause of chronic diarrhea in a heart-lung transplant recipient who was seronegative for human immunodeficiency virus. Clin Infect Dis 23:114–117.
Sax PE, Rich JD, Pieciak WS, Trnka YM. 1995. Intestinal microsporidiosis occurring in a liver transplant recipient. Transplantation 60:617–618.
Gumbo T, Hobbs RE, Carlyn C, Hall G, Isada CM. 1999. Microsporidia infection in transplant patients. Transplantation 67:482–484.
Kelkar R, Sastry PS, Kulkarni SS, Saikia TK, Parikh PM, Advani SH. 1997. Pulmonary microsporidial infection in a patient with CML undergoing allogeneic marrow transplant. Bone Marrow Transplant 19:179–182.
Mahmood MN, Keohane ME, Burd EM. 2003. Pathologic quiz case: a 45-year-old renal transplant recipient with persistent fever. Arch Pathol Lab Med 127:e224-6.
Metge S, Van Nhieu JT, Dahmane D, Grimbert P, Foulet F, Sarfati C, Bretagne S. 2000. A case of Enterocytozoon bieneusi infection in an HIV-negative renal transplant recipient. Eur J Clin Microbiol Infect Dis 19:221–223.
Field A, Paik J, Stark D, Qiu M, Morey A, Plit M, Canning E, Glanville A. 2012. Myositis due to the microsporidian Anncaliia (Brachiola) algerae in a lung transplant recipient. Transpl Infect Dis 14:169–176.
Lanternier F, Boutboul D, Menotti J, Chandesris MO, Sarfati C, Mamzer Bruneel MF, Calmus Y, Mechai F, Viard JP, Lecuit M, Bougnoux ME, Lortholary O. 2009. Microsporidiosis in solid organ transplant recipients: two Enterocytozoon bieneusi cases and review. Transpl Infect Dis 11:83–88.
Silverstein BE, Cunningham ETJ, Margolis TP, Cevallos V, Wong IG. 1997. Microsporidial keratoconjunctivitis in a patient without human immunodeficiency virus infection. Am J Ophthalmol 124:395–396.
Hocevar SN, Paddock CD, Spak CW, Rosenblatt R, Diaz-Luna H, Castillo I, Luna S, Friedman GC, Antony S, Stoddard RA, Tiller RV, Peterson T, Blau DM, Sriram RR, da Silva A, de Almeida M, Benedict T, Goldsmith CS, Zaki SR, Visvesvara GS, Kuehnert MJ, Microsporidia Transplant Transmission Investigation Team. 2014. Microsporidiosis acquired through solid organ transplantation: a public health investigation. Ann Intern Med 160:213–220.
Smith RM, Muehlenbachs A, Schaenmann J, Baxi S, Koo S, Blau D, Chin-Hong P, Thorner AR, Kuehnert MJ, Wheeler K, Liakos A, Jackson JW, Benedict T, da Silva AJ, Ritter JM, Rollin D, Metcalfe M, Goldsmith CS, Visvesvara GS, Basavaraju SV, Zaki S. 2017. Three cases of neurologic syndrome caused by donor-derived microsporidiosis. Emerg Infect Dis 23:387–395.
Goodgame R. 2003. Emerging causes of traveler's diarrhea: Cryptosporidium, Cyclospora, Isospora, and Microsporidia. Curr Infect Dis Rep 5:66–73.
Tu EY, Joslin CE. 2012. Microsporidia and Acanthamoeba: the role of emerging corneal pathogens. Eye 26:222–227.
Theng J, Chan C, Ling ML, Tan D. 2001. Microsporidial keratoconjunctivitis in a healthy contact lens wearer without human immunodeficiency virus infection. Ophthalmology 108:976–978.
Enriquez FJ, Taren D, Cruz-Lopez A, Muramoto M, Palting JD, Cruz P. 1998. Prevalence of intestinal encephalitozoonosis in Mexico. Clin Infect Dis 26:1227–1229.
Hutin YJ, Sombardier MN, Liguory O, Sarfati C, Derouin F, Modai J, Molina JM. 1998. Risk factors for intestinal microsporidiosis in patients with human immunodeficiency virus infection: a case-control study. J Infect Dis 178:904–907.
Conteas CN, Berlin OG, Lariviere MJ, Pandhumas SS, Speck CE, Porschen R, Nakaya T. 1998. Examination of the prevalence and seasonal variation of intestinal microsporidiosis in the stools of persons with chronic diarrhea and human immunodeficiency virus infection. Am J Trop Med Hyg 58:559–561.
Wuhib T, Silva TMJ, Newman RD, Garcia LS, Pereira MLD, Chaves CS, Wahlquist SP, Bryan RT, Guerrant RL, Sousa A.dQ, de Queiroz TRBS, Sears CL. 1994. Cryptosporidial and microsporidial infections in human immunodeficiency virus-infected patients in northeastern Brazil. J Infect Dis 170:494–497.
Fan NW, Wu CC, Chen TL, Yu WK, Chen CP, Lee SM, Lin PY. 2012. Microsporidial keratitis in patients with hot springs exposure. J Clin Microbiol 50:414–418.
Chan KS, Koh TH. 2015. Microsporidian eye infection from outdoor recreational activities. J Clin Microbiol 53:753–753.
Tan J, Lee P, Lai Y, Hishamuddin P, Tay J, Tan AL, Chan KS, Lin R, Tan D, Cutter J, Goh KT. 2013. Microsporidial keratoconjunctivitis after rugby tournament, Singapore. Emerg Infect Dis 19:1484–1486.
Waller T. 1979. Sensitivity of Encephalitozoon cuniculi to various temperatures, disinfectants and drugs. Lab Anim 13:227–230.
Mathis A, Weber R, Deplazes P. 2005. Zoonotic potential of the microsporidia. Clin Microbiol Rev 18:423–445.
Anane S, Attouchi H. 2010. Microsporidiosis: epidemiology, clinical data and therapy. Gastroenterol Clin Biol 34:450–464.
Deplazes P, Mathis A, Weber R. 2000. Epidemiology and zoonotic aspects of microsporidia of mammals and birds. Contrib Microbiol 6:236–260.
Fuentealba IC, Mahoney NT, Shadduck JA, Harvill J, Wicher V, Wicher K. 1992. Hepatic lesions in rabbits infected with Encephalitozoon cuniculi administered per rectum. Vet Pathol 29:536–540.
Schwartz DA, Visvesvara G, Weber R, Bryan RT. 1994. Male genital tract microsporidiosis and AIDS: prostatic abscess due to Encephalitozoon hellem. J Eukaryot Microbiol 41:61S.
Schwartz DA, Bryan RT, Hewan-Lowe KO, Weber R, Visvesvara GS, Cali A, Angritt P. 1992. Disseminated microsporidiosis (Encephalitozoon hellem) and acquired immunodeficiency syndrome. Autopsy evidence for respiratory acquisition. Arch Pathol Lab Med 116:660–668.
Hunt RD, King NW, Foster HL. 1972. Encephalitozoonosis: evidence for vertical transmission. J Infect Dis 126:212–214.
McInnes EF, Stewart CG. 1991. The pathology of subclinical infection of Encephalitozoon cuniculi in canine dams producing pups with overt encephalitozoonosis. J S Afr Vet Assoc 62:51–54.
Cama VA, Pearson J, Cabrera L, Pacheco L, Gilman R, Meyer S, Ortega Y, Xiao L. 2007. Transmission of Enterocytozoon bieneusi between a child and guinea pigs. J Clin Microbiol 45:2708–2710.
Karim MR, Dong H, Yu F, Jian F, Zhang L, Wang R, Zhang S, Rume FI, Ning C, Xiao L. 2014. Genetic diversity in Enterocytozoon bieneusi isolates from dogs and cats in China: host specificity and public health implications. J Clin Microbiol 52:3297–3302.
Lores B, Del Aguila C, Arias C. 2002. Enterocytozoon bieneusi (microsporidia) in faecal samples from domestic animals from Galicia, Spain. Mem Inst Oswaldo Cruz 97:941–945.
Bornay-Llinares FJ, da Silva AJ, Moura H, Schwartz DA, Visvesvara GS, Pieniazek NJ, Cruz-López A, Hernández-Jaúregui P, Guerrero J, Enriquez FJ. 1998. Immunologic, microscopic, and molecular evidence of Encephalitozoon intestinalis (Septata intestinalis) infection in mammals other than humans. J Infect Dis 178:820–826.
Valencáková A, Balent P, Húska M, Novotný F, Luptáková L. 2006. First report on Encephalitozoon intestinalis infection of swine in Europe. Acta Vet Hung 54:407–411.
Haro M, Izquierdo F, Henriques-Gil N, Andrés I, Alonso F, Fenoy S, del Águila C. 2005. First detection and genotyping of human-associated microsporidia in pigeons from urban parks. Appl Environ Microbiol 71:3153.
Snowden K, Logan K, Didier E. 1999. Encephalitozoon cuniculi strain III is a cause of encephalitozoonosis in both humans and dogs. J Infect Dis 180:2086–2088.
Black SS, Steinohrt LA, Bertucci DC, Rogers LB, Didier ES. 1997. Encephalitozoon hellem in budgerigars (Melopsittacus undulatus). Vet Pathol 34:189–198.
Santín M, Fayer R. 2011. Microsporidiosis: Enterocytozoon bieneusi in domesticated and wild animals. Res Vet Sci 90:363–371.
Stentiford GD, Becnel J, Weiss LM, Keeling PJ, Didier ES, Williams BP, Bjornson S, Kent ML, Freeman MA, Brown MJF, Troemel ER, Roesel K, Sokolova Y, Snowden KF, Solter L. 2016. Microsporidia—emergent pathogens in the global food chain. Trends Parasitol 32:336–348.
Askari Z, Mirjalali H, Mohebali M, Zarei Z, Shojaei S, Rezaeian T, Rezaeian M. 2015. Molecular detection and identification of zoonotic microsporidia spore in fecal samples of some animals with close-contact to human. Iran J Parasitol 10:381–388.
Vahedi SM, Jamshidi S, Shayan P, Bokaie S, Ashrafi Tamai I, Javanmard E, Mirjalali H. 2020. Intestinal microsporidia infection among cat owners and non-pet owners in Iran: a case-control study. Parasitol Res 119:1903–1913.
Cissé G. 2019. Food-borne and water-borne diseases under climate change in low- and middle-income countries: further efforts needed for reducing environmental health exposure risks. Acta Trop 194:181–188.
Franzen C, Müller A. 1999. Molecular techniques for detection, species differentiation, and phylogenetic analysis of microsporidia. Clin Microbiol Rev 12:243–285.
Paterson RRM, Lima N. 2015. Molecular biology of food and water borne mycotoxigenic and mycotic fungi. CRC Press, Boca Raton, FL.
Moss JA, Snyder RA. 2017. Biofilms for monitoring presence of microsporidia in environmental water. J Eukaryot Microbiol 64:533–538.
Fournier S, Liguory O, Santillana-Hayat M, Guillot E, Sarfati C, Dumoutier N, Molina J-M, Derouin F. 2000. Detection of microsporidia in surface water: a one-year follow-up study. FEMS Immunol Med Microbiol 29:95–100.
Chen J-S, Hsu B-M, Tsai H-C, Chen Y-P, Huang T-Y, Li K-Y, Ji D-D, Lee H-S. 2018. Molecular surveillance of Vittaforma-like microsporidia by a small-volume procedure in drinking water source in Taiwan: evidence for diverse and emergent pathogens. Environ Sci Pollut Res Int 25:18823–18837.
Slodkowicz-Kowalska A, Graczyk TK, Tamang L, Jedrzejewski S, Nowosad A, Zduniak P, Solarczyk P, Girouard AS, Majewska AC. 2006. Microsporidian species known to infect humans are present in aquatic birds: implications for transmission via water? Appl Environ Microbiol 72:4540–4544.
Slifko TR, Smith HV, Rose JB. 2000. Emerging parasite zoonoses associated with water and food. Int J Parasitol 30:1379–1393.
Orlandi PA, Chu D-MT, Bier JW, Jackson GJ. 2002. Parasites and the food supply. Food Technol 56:72–79.
Calvo M, Carazo M, Arias ML, Chaves C, Monge R, Chinchilla M. 2004. Prevalence of Cyclospora sp., Cryptosporidium sp., microsporidia and fecal coliform determination in fresh fruit and vegetables consumed in Costa Rica. Archiv Latinoam Nutr 54:428–432. (In Spanish.)
Javanmard E, Mirjalali H, Niyyati M, Jalilzadeh E, Seyed Tabaei SJ, Asadzadeh Aghdaei H, Nazemalhosseini-Mojarad E, Zali MR. 2018. Molecular and phylogenetic evidences of dispersion of human-infecting microsporidia to vegetable farms via irrigation with treated wastewater: one-year follow up. Int J Hyg Environ Health 221:642–651.
Sak B, Vecková T, Brdíčková K, Smetana P, Hlásková L, Kicia M, Holubová N, McEvoy J, Kváč M. 2019. Experimental Encephalitozoon cuniculi infection acquired from fermented meat products. Foodborne Pathog Dis 16:394–398.
Vu-Khac H, Nguyen Thi Thanh T, Thu G, Le CH, Nguyen VD. 2018. Vertical transmission and early diagnosis of the microsporidian Enterocytozoon hepatonaei in whiteleg shrimp Penaeus vannamei. J Pure Appl Microbiol 12:1125–1131.
Goertz D, Solter LF, Linde A. 2007. Horizontal and vertical transmission of a Nosema sp. (Microsporidia) from Lymantria dispar (L.) (Lepidoptera: Lymantriidae). J Invertebr Pathol 95:9–16.
Terry RS, Smith JE, Bouchon D, Rigaud T, Duncanson P, Sharpe RG, Dunn AM. 1999. Ultrastructural characterisation and molecular taxonomic identification of Nosema granulosis n. sp., a transovarially transmitted feminising (TTF) microsporidium. J Eukaryot Microbiol 46:492–499.
Dunn AM, Terry RS, Smith JE. 2001. Transovarial transmission in the microsporidia. Adv Parasitol 48:57–100.
Stentiford GD, Feist SW, Stone DM, Bateman KS, Dunn AM. 2013. Microsporidia: diverse, dynamic, and emergent pathogens in aquatic systems. Trends Parasitol 29:567–578.
Bulnheim HP, Vávra J. 1968. Infection by the microsporidian Octosporea effeminans sp. n., and its sex determining influence in the amphipod Gammarus duebeni. J Parasitol 54:241–248.
Williams BAP. 2009. Unique physiology of host-parasite interactions in microsporidia infections. Cell Microbiol 11:1551–1560.
Didier ES, Snowden KF, Shadduck JA. 1998. Biology of microsporidian species infecting mammals. Adv Parasitol 40:283–320.
Snowden KF, Didier ES, Orenstein JM, Shadduck JA. 1998. Animal models of human microsporidial infections. Lab Anim Sci 48:589–592.
Mota P, Rauch CA, Edberg SC. 2000. Microsporidia and Cyclospora: epidemiology and assessment of risk from the environment. Crit Rev Microbiol 26:69–90.
Poley JD, Sutherland BJG, Fast MD, Koop BF, Jones SRM. 2017. Effects of the vertically transmitted microsporidian Facilispora margolisi and the parasiticide emamectin benzoate on salmon lice (Lepeophtheirus salmonis). BMC Genomics 18:630.
Work TM. 2019. Ecology of invertebrate diseases. J Wildl Dis 55:742–744.
Birthistle K, Moore P, Hay P. 1996. Microsporidia: a new sexually transmissable cause of urethritis. Genitourin Med 72:445.
Han B, Takvorian PM, Weiss LM. 2020. Invasion of host cells by microsporidia. Front Microbiol 11:172.
Wittner M, Weiss LM (ed). 1999. The microsporidia and microsporidiosis. ASM Press, Washington, DC.
Frixione E, Ruiz L, Santillán M, de Vargas LV, Tejero JM, Undeen AH. 1992. Dynamics of polar filament discharge and sporoplasm expulsion by microsporidian spores. Cell Motil Cytoskeleton 22:38–50.
Weidner E. 1972. Ultrastructural study of microsporidian invasion into cells. Z Parasitenkd 40:227–242.
Erickson B, Blanquet R. 1969. The occurrence of chitin in the spore wall of Glugea weissenbergi. J Invertebr Pathol 14:358–364.
Brosson D, Kuhn L, Prensier G, Vivares CP, Texier C. 2005. The putative chitin deacetylase of Encephalitozoon cuniculi: a surface protein implicated in microsporidian spore-wall formation. FEMS Microbiol Lett 247:81–90.
Urch JE, Hurtado-Guerrero R, Brosson D, Liu Z, Eijsink VG, Texier C, van Aalten DM. 2009. Structural and functional characterization of a putative polysaccharide deacetylase of the human parasite Encephalitozoon cuniculi. Protein Sci 18:1197–1209.
Takvorian PM, Han B, Cali A, Rice WJ, Gunther L, Macaluso F, Weiss LM. 2020. An ultrastructural study of the extruded polar tube of Anncaliia algerae (Microsporidia). J Eukaryot Microbiol 67:28–44.
Hayman JR, Southern TR, Nash TE. 2005. Role of sulfated glycans in adherence of the microsporidian Encephalitozoon intestinalis to host cells in vitro. Infect Immun 73:841–848.
Dolgikh VV, Semenov PB. 2003. The spore wall and polar tube proteins of the microsporidian Nosema grylli: the major spore wall protein is released before spore extrusion. Tsitologiia 45:324–329.
Hayman JR, Hayes SF, Amon J, Nash TE. 2001. Developmental expression of two spore wall proteins during maturation of the microsporidian Encephalitozoon intestinalis. Infect Immun 69:7057–7066.
Xu Y, Takvorian P, Cali A, Wang F, Zhang H, Orr G, Weiss LM. 2006. Identification of a new spore wall protein from Encephalitozoon cuniculi. Infect Immun 74:239–247.
Peuvel-Fanget I, Polonais V, Brosson D, Texier C, Kuhn L, Peyret P, Vivares C, Delbac F. 2006. EnP1 and EnP2, two proteins associated with the Encephalitozoon cuniculi endospore, the chitin-rich inner layer of the microsporidian spore wall. Int J Parasitol 36:309–318.
Cai S, Lu X, Qiu H, Li M, Feng Z. 2011. Identification of a Nosema bombycis (Microsporidia) spore wall protein corresponding to spore phagocytosis. Parasitology 138:1102–1109.
Wu Z, Li Y, Pan G, Zhou Z, Xiang Z. 2009. SWP25, a novel protein associated with the Nosema bombycis endospore. J Eukaryot Microbiol 56:113–118.
Ambrosioni J, van Delden C, Krause KH, Bouchuiguir-Wafa C, Nagy M, Passweg J, Chalandon Y. 2009. Invasive microsporidiosis in allogeneic haematopoietic SCT recipients. Bone Marrow Transpl 45:1249–1251.
Wu Z, Li Y, Pan G, Tan X, Hu J, Zhou Z, Xiang Z. 2008. Proteomic analysis of spore wall proteins and identification of two spore wall proteins from Nosema bombycis (Microsporidia). Proteomics 8:2447–2461.
Wang JY, Chambon C, Lu CD, Huang KW, Vivares CP, Texier C. 2007. A proteomic-based approach for the characterization of some major structural proteins involved in host-parasite relationships from the silkworm parasite Nosema bombycis (Microsporidia). Proteomics 7:1461–1472.
Bouzahzah B, Weiss LM. 2010. Glycosylation of the major polar tube protein of Encephalitozoon cuniculi. Parasitol Res 107:761–764.
Xu Y, Takvorian PM, Cali A, Orr G, Weiss LM. 2004. Glycosylation of the major polar tube protein of Encephalitozoon hellem, a microsporidian parasite that infects humans. Infect Immun 72:6341–6350.
Dolgikh VV, Semenov PB, Beznusenko GV. 2007. Protein glycosylation in the spores of the microsporidia Paranosema (Antonospora) grylli. Tsitologiia 49:607–613. (In Russian.)
Ghosh K, Nieves E, Keeling P, Pombert JF, Henrich PP, Cali A, Weiss LM. 2011. Branching network of proteinaceous filaments within the parasitophorous vacuole of Encephalitozoon cuniculi and Encephalitozoon hellem. Infect Immun 79:1374–1385.
Li Y, Wu Z, Pan G, He W, Zhang R, Hu J, Zhou Z. 2009. Identification of a novel spore wall protein (SWP26) from microsporidia Nosema bombycis. Int J Parasitol 39:391–398.
Chen L, Li R, You Y, Zhang K, Zhang L. 2017. A novel spore wall protein from Antonospora locustae (Microsporidia: Nosematidae) contributes to sporulation. J Eukaryot Microbiol 64:779–791.
Yang D, Pan G, Dang X, Shi Y, Li C, Peng P, Luo B, Bian M, Song Y, Ma C. 2015. Interaction and assembly of two novel proteins in the spore wall of the microsporidian species Nosema bombycis and their roles in adherence to and infection of host cells. Infect Immun 83:1715–1731.
Yang D, Dang X, Peng P, Long M, Ma C, Qin JJG, Wu H, Liu T, Zhou X, Pan G. 2014. NbHSWP11, a microsporidia Nosema bombycis protein, localizing in the spore wall and membranes, reduces spore adherence to host cell BME. J Parasitol 100:623–633.
Wang Y, Dang X, Ma Q, Liu F, Pan G, Li T, Zhou Z. 2015. Characterization of a novel spore wall protein NbSWP16 with proline-rich tandem repeats from Nosema bombycis (microsporidia). Parasitology 142:534–542.
Jaroenlak P, Boakye DW, Vanichviriyakit R, Williams BA, Sritunyalucksana K, Itsathitphaisarn O. 2018. Identification, characterization and heparin binding capacity of a spore-wall, virulence protein from the shrimp microsporidian, Enterocytozoon hepatopenaei (EHP). Parasite Vectors 11:177.
Barclay AN. 2003. Membrane proteins with immunoglobulin-like domains—a master superfamily of interaction molecules. Sem Immunol 15:215–223.
Leonard CA, Hayman JR. 2017. Role of host cell integrins in the microsporidium Encephalitozoon intestinalis adherence and infection in vitro. FEMS Microbiol Lett 364.
Lv Q, Wang L, Fan Y, Meng X, Liu K, Zhou B, Chen J, Pan G, Long M, Zhou Z. 2020. Identification and characterization a novel polar tube protein (NbPTP6) from the microsporidian Nosema bombycis. Parasit Vectors 13:475.
Keohane EM, Orr GA, Takvorian PM, Cali A, Tanowitz HB, Wittner M, Weiss LM. 1996. Purification and characterization of a microsporidian polar tube protein. Mol Biochem Parasitol 79:255–259.
Delbac F, Duffieux F, David D, Metenier G, Vivares CP. 1998. Immunocytochemical identification of spore proteins in two microsporidia, with emphasis on extrusion apparatus. J Eukaryot Microbiol 45:224–231.
Delbac F, Peuvel I, Metenier G, Peyretaillade E, Vivares CP. 2001. Microsporidian invasion apparatus: identification of a novel polar tube protein and evidence for clustering of ptp1 and ptp2 genes in three Encephalitozoon species. Infect Immun 69:1016–1024.
Xu Y, Takvorian P, Cali A, Weiss LM. 2003. Lectin binding of the major polar tube protein (PTP1) and its role in invasion. J Eukaryot Microbiol 50:600–601.
Peuvel I, Peyret P, Metenier G, Vivares CP, Delbac F. 2002. The microsporidian polar tube: evidence for a third polar tube protein (PTP3) in Encephalitozoon cuniculi. Mol Biochem Parasitol 122:69–80.
Bouzahzah B, Nagajyothi F, Ghosh K, Takvorian PM, Cali A, Tanowitz HB, Weiss LM. 2010. Interactions of Encephalitozoon cuniculi polar tube proteins. Infect Immun 78:2745–2753.
Han B, Polonais V, Sugi T, Yakubu R, Takvorian PM, Cali A, Maier K, Long M, Levy M, Tanowitz HB, Pan G, Delbac F, Zhou Z, Weiss LM. 2017. The role of microsporidian polar tube protein 4 (PTP4) in host cell infection. PLoS Pathog 13:e1006341.
Takvorian PM, Weiss LM, Cali A. 2005. The early events of Brachiola algerae (Microsporidia) infection: spore germination, sporoplasm structure, and development within host cells. Folia Parasitol (Praha) 52:118–129.
Han B, Ma Y, Tu V, Tomita T, Mayoral J, Williams T, Horta A, Huang H, Weiss LM. 2019. Microsporidia interact with host cell mitochondria via voltage-dependent anion channels using sporoplasm surface protein 1. mBio 10:e01944-19.
Cali A, Takvorian PM. 2014. Developmental morphology and life cycles of the microsporidia, p 71–133. In Weiss LM, Becnel JJ (ed) Microsporidia: pathogens of opportunity. Wiley Press, Hoboken, NJ.
Goldberg AV, Molik S, Tsaousis AD, Neumann K, Kuhnke G, Delbac F, Vivares CP, Hirt RP, Lill R, Embley TM. 2008. Localization and functionality of microsporidian iron-sulphur cluster assembly proteins. Nature 452:624–628.
Tamim El Jarkass H, Reinke AW. 2020. The ins and outs of host-microsporidia interactions during invasion, proliferation and exit. Cell Microbiol 22:e13247.
He Q, Vossbrinck CR, Yang Q, Meng X-Z, Luo J, Pan G-Q, Zhou Z-Y, Li T. 2019. Evolutionary and functional studies on microsporidian ATP-binding cassettes: insights into the adaptation of microsporidia to obligated intracellular parasitism. Infect Genet Evol 68:136–144.
Tsaousis AD, Kunji ER, Goldberg AV, Lucocq JM, Hirt RP, Embley TM. 2008. A novel route for ATP acquisition by the remnant mitochondria of Encephalitozoon cuniculi. Nature 453:553–556.
Major P, Sendra KM, Dean P, Williams TA, Watson AK, Thwaites DT, Embley TM, Hirt RP. 2019. A new family of cell surface located purine transporters in microsporidia and related fungal endoparasites. Elife 8:e47037.
Hacker C, Howell M, Bhella D, Lucocq J. 2014. Strategies for maximizing ATP supply in the microsporidian Encephalitozoon cuniculi: direct binding of mitochondria to the parasitophorous vacuole and clustering of the mitochondrial porin VDAC. Cell Microbiol 16:565–579.
Scanlon M, Leitch GJ, Visvesvara GS, Shaw AP. 2004. Relationship between the host cell mitochondria and the parasitophorous vacuole in cells infected with Encephalitozoon microsporidia. J Eukaryot Microbiol 51:81–87.
Kotkova M, Sak B, Kvetonova D, Kvac M. 2013. Latent microsporidiosis caused by Encephalitozoon cuniculi in immunocompetent hosts: a murine model demonstrating the ineffectiveness of the immune system and treatment with albendazole. PLoS One 8:e60941.
Sak B, Kotkova M, Hlaskova L, Kvac M. 2017. Limited effect of adaptive immune response to control encephalitozoonosis. Parasite Immunol 39:e12496.
Hermanek J, Koudela B, Kucerova Z, Ditrich O, Travnicek J. 1993. Prophylactic and therapeutic immune reconstitution of SCID mice infected with Encephalitozoon cuniculi. Folia Parasitol (Praha) 40:287–291.
Schmidt EC, Shadduck JA. 1984. Mechanisms of resistance to the intracellular protozoan Encephalitozoon cuniculi in mice. J Immunol 133:2712–2719.
Didier ES, Bowers LC, Martin AD, Kuroda MJ, Khan IA, Didier PJ. 2010. Reactive nitrogen and oxygen species, and iron sequestration contribute to macrophage-mediated control of Encephalitozoon cuniculi (Phylum Microsporidia) infection in vitro and in vivo. Microbes Infect 12:1244–1251.
Bywater JE, Kellett BS. 1979. Humoral immune response to natural infection with Encephalitozoon cuniculi in rabbits. Lab Anim 13:293–297.
Furuya K, Omura M, Kudo S, Sugiura W, Azuma H. 2008. Recognition profiles of microsporidian Encephalitozoon cuniculi polar tube protein 1 with human immunoglobulin M antibodies. Parasite Immunol 30:13–21.
Achbarou A, Ombrouck C, Gneragbe T, Charlotte F, Renia L, Desportes-Livage I, Mazier D. 1996. Experimental model for human intestinal microsporidiosis in interferon gamma receptor knockout mice infected by Encephalitozoon intestinalis. Parasite Immunol 18:387–392.
Khan IA, Moretto M. 1999. Role of gamma interferon in cellular immune response against murine Encephalitozoon cuniculi infection. Infect Immun 67:1887–1893.
Moretto MM, Lawlor EM, Khan IA. 2010. Lack of interleukin-12 in p40-deficient mice leads to poor CD8+ T-cell immunity against Encephalitozoon cuniculi infection. Infect Immun 78:2505–2511.
Khan IA, Schwartzman JD, Kasper LH, Moretto M. 1999. CD8+ CTLs are essential for protective immunity against Encephalitozoon cuniculi infection. J Immunol 162:6086–6091.
Moretto MM, Khan IA, Weiss LM. 2012. Gastrointestinal cell mediated immunity and the microsporidia. PLoS Pathog 8:e1002775.
Moretto MM, Harrow DI, Khan IA. 2015. Effector CD8 T cell immunity in microsporidial infection: a lone defense mechanism. Semin Immunopathol 37:281–287.
Moretto MM, Weiss LM, Combe CL, Khan IA. 2007. IFN-gamma-producing dendritic cells are important for priming of gut intraepithelial lymphocyte response against intracellular parasitic infection. J Immunol 179:2485–2492.
Moretto MM, Harrow DI, Hawley TS, Khan IA. 2015. Interleukin-12-producing CD103+ CD11b CD8+ dendritic cells are responsible for eliciting gut intraepithelial lymphocyte response against Encephalitozoon cuniculi. Infect Immun 83:4719–4730.
Lawlor EM, Moretto MM, Khan IA. 2010. Optimal CD8 T-cell response against Encephalitozoon cuniculi is mediated by Toll-like receptor 4 upregulation by dendritic cells. Infect Immun 78:3097–3102.
Fischer J, Suire C, Hale-Donze H. 2008. Toll-like receptor 2 recognition of the microsporidia Encephalitozoon spp. induces nuclear translocation of NF-kappaB and subsequent inflammatory responses. Infect Immun 76:4737–4744.
Gigley JP, Khan IA. 2011. Plasmacytoid DC from aged mice down-regulate CD8 T cell responses by inhibiting cDC maturation after Encephalitozoon cuniculi infection. PLoS One 6:e20838.
Ramanan P, Pritt BS. 2014. Extraintestinal microsporidiosis. J Clin Microbiol 52:3839–3844.
Didier ES, Weiss LM. 2011. Microsporidiosis: not just in AIDS patients. Curr Opin Infect Dis 24:490–495.
Desportes-Livage I, Datry A. 2005. Infections à microsporidies, Isospora et Sarcocystis. EMC Malad Infect 2:178–196.
Conteas CN, Berlin OGW, Ash LR, Pruthi JS. 2000. Therapy for human gastrointestinal microsporidiosis. Am J Trop Med Hyg 63:121–127.
Weber R, Muller A, Spycher MA, Opravil M, Ammann R, Briner J. 1992. Intestinal Enterocytozoon bieneusi microsporidiosis in an HIV-infected patient—diagnosis by ileo-colonoscopic biopsies and long-term follow up. Clin Investig 70:1019–1023.
Molina J-M, Sarfati C, Beauvais B, Lemann M, Lesourd A, Ferchal F, Casin I, Lagrange P, Modigliani R, Derouin F, Modal J. 1993. Intestinal microsporidiosis in human immunodeficiency virus-infected patients with chronic unexplained diarrhea—prevalence and clinical and biologic features. J Infect Dis 167:217–221.
Pol S, Romana CA, Richard S, Amouyal P, Desportes-Livage I, Carnot F, Pays JF, Berthelot P. 1993. Microsporidia infection in patients with the human immunodeficiency virus and unexplained cholangitis. N Engl J Med 328:95–99.
Espern A, Morio F, Miegeville M, Illa H, Abdoulaye M, Meyssonnier V, Adehossi E, Lejeune A, Phung DC, Besse B, Gay-Andrieu F. 2007. Molecular study of microsporidiosis due to Enterocytozoon bieneusi and Encephalitozoon intestinalis among human immunodeficiency virus-infected patients from two geographical areas: Niamey, Niger, and Hanoi, Vietnam. J Clin Microbiol 45:2999–3002.
del Aguila C, Lopez-Velez R, Fenoy S, Turrientes C, Cobo J, Navajas R, Visvesvara GS, Croppo GP, Da Silva AJ, Pieniazek NJ. 1997. Identification of Enterocytozoon bieneusi spores in respiratory samples from an AIDS patient with a 2-year history of intestinal microsporidiosis. J Clin Microbiol 35:1862–1866.
Hartskeerl RA, Schuitema AR, van Gool T, Terpstra WJ. 1993. Genetic evidence for the occurrence of extra-intestinal Enterocytozoon bieneusi infections. Nucleic Acids Res 21:4150–4150.
Orenstein JM, Gaetz HP, Yachnis AT, Frankel SS, Mertens RB, Didier ES. 1997. Disseminated microsporidiosis in AIDS: are any organs spared? AIDS 11:385–386.
Sheth SG, Bates C, Federman M, Chopra S. 1997. Fulminant hepatic failure caused by microsporidial infection in a patient with AIDS. AIDS 11:553–554.
Schwartz DA, Sobottka I, Leitch GJ, Cali A, Visvesvara GS. 1996. Pathology of microsporidiosis: emerging parasitic infections in patients with acquired immunodeficiency syndrome. Arch Pathol Lab Med 120:173–188.
Soule JB, Halverson AL, Becker RB, Pistole MC, Orenstein JM. 1997. A patient with acquired immunodeficiency syndrome and untreated Encephalitozoon (Septata) intestinalis microsporidiosis leading to small bowel perforation. Response to albendazole. Arch Pathol Lab Med 121:880–887.
Zender HO, Arrigoni E, Eckert J, Kapanci Y. 1989. A case of Encephalitozoon cuniculi peritonitis in a patient with AIDS. Am J Clin Pathol 92:352–356.
Mertens RB, Didier ES, Fishbein MC, Bertucci DC, Rogers LB, Orenstein JM. 1997. Encephalitozoon cuniculi microsporidiosis: infection of the brain, heart, kidneys, trachea, adrenal glands, and urinary bladder in a patient with AIDS. Mod Pathol 10:68–77.
Kester KE, Turiansky GW, McEvoy PL. 1998. Nodular cutaneous microsporidiosis in a patient with AIDS and successful treatment with long-term oral clindamycin therapy. Ann Intern Med 128:911–914.
Kester KE, Visvesara GS, McEvoy P. 2000. Organism responsible for nodular cutaneous microsporidiosis in a patient with AIDS. Ann Intern Med 133:925.
Schwartz DA, Visvesvara GS, Leitch GJ, Tashjian L, Pollack M, Holden J, Bryan RT. 1993. Pathology of symptomatic microsporidial (Encephalitozoon hellem) bronchiolitis in the acquired immunodeficiency syndrome: a new respiratory pathogen diagnosed from lung biopsy, bronchoalveolar lavage, sputum, and tissue culture. Hum Pathol 24:937–943.
Sobottka I, Albrecht H, Schafer H, Schottelius J, Visvesvara GS, Laufs R, Schwartz DA. 1995. Disseminated Encephalitozoon (Septata) intestinalis infection in a patient with AIDS: novel diagnostic approaches and autopsy-confirmed parasitological cure following treatment with albendazole. J Clin Microbiol 33:2948–2952.
Tosoni A, Nebuloni M, Ferri A, Bonetto S, Antinori S, Scaglia M, Xiao L, Moura H, Visvesvara GS, Vago L, Costanzi G. 2002. Disseminated microsporidiosis caused by Encephalitozoon cuniculi III (dog type) in an Italian AIDS patient: a retrospective study. Mod Pathol 15:577–583.
Fournier S, Liguory O, Sarfati C, David-Ouaknine F, Derouin F, Decazes J, Molina J. 2000. Disseminated infection due to Encephalitozoon cuniculi in a patient with AIDS: case report and review. HIV Med 1:155–161.
Galvan AL, Sanchez AM, Valentin MA, Henriques-Gil N, Izquierdo F, Fenoy S, del Aguila C. 2011. First cases of microsporidiosis in transplant recipients in Spain and review of the literature. J Clin Microbiol 49:1301–1306.
Tanveer N, Barman S. 2015. Microsporidium infection and perforation peritonitis: a rare association. Indian J Sex Transm Dis AIDS 36:188–191.
Willson R, Harrington R, Stewart B, Fritsche T. 1995. Human immunodeficiency virus 1-associated necrotizing cholangitis caused by infection with Septata intestinalis. Gastroenterology 108:247–251.
Belcher JW, Jr, Guttenberg SA, Schmookler BM. 1997. Microsporidiosis of the mandible in a patient with acquired immunodeficiency syndrome. J Oral Maxillofac Surg 55:424–426.
Dore GJ, Marriott DJ, Hing MC, Harkness JL, Field AS. 1995. Disseminated microsporidiosis due to Septata intestinalis in nine patients infected with the human immunodeficiency virus: response to therapy with albendazole. Clin Infect Dis 21:70–76.
Terada S, Reddy KR, Jeffers LJ, Cali A, Schiff ER. 1987. Microsporidan hepatitis in the acquired immunodeficiency syndrome. Ann Intern Med 107:61–62.
Filho MM, Ribeiro HB, Paula LJ, Nishioka SA, Tamaki WT, Costa R, Siqueira SF, Kawakami JT, Higuchi ML. 2009. Images in cardiovascular medicine. Endocarditis secondary to microsporidia: giant vegetation in a pacemaker user. Circulation 119:e386–e388.
Kicia M, Wesolowska M, Kopacz Z, Kvac M, Sak B, Sokulska M, Cebulski K, Hendrich AB, Pozowski A. 2018. Disseminated infection of Encephalitozoon cuniculi associated with osteolysis of hip periprosthetic tissue. Clin Infect Dis 67:1228–1234.
Bergquist NR, Stintzing G, Smedman L, Waller T, Andersson T. 1984. Diagnosis of encephalitozoonosis in man by serological tests. Br Med J (Clin Res Ed) 288:902–902.
Ditrich O, Chrdle A, Sak B, Chmelik V, Kubale J, Dykova I, Kvac M. 2011. Encephalitozoon cuniculi genotype I as a causative agent of brain abscess in an immunocompetent patient. J Clin Microbiol 49:2769–2771.
Weber R, Kuster H, Visvesvara GS, Bryan RT, Schwartz DA, Luthy R. 1993. Disseminated microsporidiosis due to Encephalitozoon hellem—pulmonary colonization, microhematuria, and mild conjunctivitis in a patient with AIDS. Clin Infect Dis 17:415–419.
Franzen C, Mueller A, Salzberger B, Fatkenhauer G, Diehl V, Schrappe M. 1996. Chronic rhinosinusitis in patients with AIDS: potential role of microsporidia. AIDS (London) 10:687–688.
Lewis NL, Francis IC, Hawkins GS, Coroneo MT. 2003. Bilateral microsporidial keratoconjunctivitis in an immunocompetent non-contact lens wearer. Cornea 22:374–376.
Friedberg DN, Stenson SM, Orenstein JM, Tierno PM, Charles NC. 1990. Microsporidial keratoconjunctivitis in acquired immunodeficiency syndrome. Arch Ophthalmol 108:504–508.
Metcalfe TW, Doran RM, Rowlands PL, Curry A, Lacey CJ. 1992. Microsporidial keratoconjunctivitis in a patient with AIDS. Br J Ophthalmol 76:177–178.
Lowder CY, Meisler DM, McMahon JT, Longworth DL, Rutherford I. 1990. Microsporidia infection of the cornea in a man seropositive for human immunodeficiency virus. Am J Ophthalmol 109:242–244.
Rastrelli PD, Didier E, Yee RW. 1994. Microsporidial keratitis. Opthalmol Clin North Am 7:617–631.
Anderson NW, Muehlenbachs A, Arif S, Bruminhent J, Deziel PJ, Razonable RR, Wilhelm MP, Metcalfe MG, Qvarnstrom Y, Pritt BS. 2019. A fatal case of disseminated microsporidiosis due to Anncaliia algerae in a renal and pancreas allograft recipient. Open Forum Infect Dis 6:ofz285.
Watts MR, Chan RC, Cheong EY, Brammah S, Clezy KR, Tong C, Marriott D, Webb CE, Chacko B, Tobias V, Outhred AC, Field AS, Prowse MV, Bertouch JV, Stark D, Reddel SW. 2014. Anncaliia algerae microsporidial myositis. Emerg Infect Dis 20:185–191.
Coyle CM, Weiss LM, Rhodes LV 3rd, Cali A, Takvorian PM, Brown DF, Visvesvara GS, Xiao L, Naktin J, Young E, Gareca M, Colasante G, Wittner M. 2004. Fatal myositis due to the microsporidian Brachiola algerae, a mosquito pathogen. N Engl J Med 351:42–47.
Weiss LM, Keohane EM. 1999. Microsporidia at the turn of the millenium: Raleigh 1999. J Eukaryot Microbiol 46:3S–5S.
Cali A, Neafie R, Weiss LM, Ghosh K, Vergara RB, Gupta R, Takvorian PM. 2010. Human vocal cord infection with the microsporidium Anncaliia algerae. J Eukaryot Microbiol 57:562–567.
Visvesvara GS, Moura H, Leitch GJ, Schwartz DA, Xiao LX. 2005. Public health importance of Brachiola algerae (Microsporidia)—an emerging pathogen of humans. Folia Parasitol (Praha) 52:83–94.
Sutrave G, Maundrell A, Keighley C, Jennings Z, Brammah S, Wang M-X, Pamphlett R, Webb CE, Stark D, Englert H. 2018. Anncaliia algerae microsporidial myositis, New South Wales, Australia. Emerg Infect Dis 24:1528.
Visvesvara GS, Belloso M, Moura H, Da SA, Moura IN, Leitch GJ, Schwartz DA, Chevez-Barrios P, Wallace S, Pieniazek NJ, Goosey JD. 1999. Isolation of Nosema algerae from the cornea of an immunocompetent patient. J Eukaryot Microbiol 46:10S.
Sood AB, Debiec MR, Yeh S, Grossniklaus HE, Randleman JB. 2016. Microsporidial stromal keratitis and endophthalmitis in an immunocompetent patient. J Ophthalmic Inflamm Infect 6:30.
Weiss LM. 2014. Clinical syndromes associated with microsporidiosis, p 371–401. In Weiss LM, Becnel JJ (ed), Microsporidia: pathogens of opportunity. Wiley Blackwell, Oxford, United Kingdom.
Margileth AM, Strano AJ, Chandra R, Neafie R, Blum M, McCully RM. 1973. Disseminated nosematosis in an immunologically compromised infant. Arch Pathol 95:145–150.
Davis RM, Font RL, Keisler MS, Shadduck JA. 1990. Corneal microsporidiosis: a case report including ultrastructural observations. Ophthalmology 97:953–957.
Font RL, Samaha AN, Keener MJ, Chevez-Barrios P, Goosey JD. 2000. Corneal microsporidiosis: report of case, including electron microscopic observations. Ophthalmology 107:1769–1775.
Font RL, Su GW, Matoba AY. 2003. Microsporidial stromal keratitis. Arch Ophthalmol 121:1045–1047.
Rauz S. 2004. Ultrastructural examination of two cases of stromal microsporidial keratitis. J Med Microbiol 53:775–781.
Huang H-Y, Wu C-L, Lin S-H, Lin W-C, Huang F-C, Hung J-H, Tseng S-H. 2020. Microsporidial stromal keratitis: characterisation of clinical features, ultrastructural study by electron microscopy and efficacy of different surgical modalities. Br J Ophthalmol 104:1613–1620.
Sulaiman IM, Matos O, Lobo ML, Xiao L. 2003. Identification of a new microsporidian parasite related to Vittaforma corneae in HIV-positive and HIV-negative patients from Portugal. J Eukaryot Microbiol 50:586–590.
Reddy AK, Balne PK, Gaje K, Garg P. 2011. PCR for the diagnosis and species identification of microsporidia in patients with keratitis. Clin Microbiol Infect 17:476–478.
Weber R, Bryan RT. 1994. Microsporidial infections in immunodeficient and immunocompetent patients. Clin Infect Dis 19:517–521.
Hollister WS, Canning EU, Weidner E, Field AS, Kench J, Marriott DJ. 1996. Development and ultrastructure of Trachipleistophora hominis n.g., n.sp. after in vitro isolation from an AIDS patient and inoculation into athymic mice. Parasitology 112:143–154.
Chupp GL, Alroy J, Adelman LS, Breen JC, Skolnik PR. 1993. Myositis due to Pleistophora (Microsporidia) in a patient with AIDS. Clin Infect Dis 16:15–21.
Ledford DK, Overman MD, Gonzalvo A, Cali A, Mester SW, Lockey RF. 1985. Microsporidiosis myositis in a patient with the acquired immunodeficiency syndrome. Ann Int Med 102:628–630.
Curry A, Beeching NJ, Gilbert JD, Scott G, Rowland PL, Currie BJ. 2005. Trachipleistophora hominis infection in the myocardium and skeletal muscle of a patient with AIDS. J Infect 51:e139–e144.
Vavra J, Yachnis AT, Shadduck JA, Orenstein JM. 1998. Microsporidia of the genus Trachipleistophora—causative agents of human microsporidiosis: description of Trachipleistophora anthropophthera n. sp. (Protozoa: Microsporidia). J Eukaryot Microbiol 45:273–283.
Pariyakanok L, Jongwutiwes S. 2005. Keratitis caused by Trachipleistophora anthropopthera. J Infect 51:325–328.
Grau A, Valls ME, Williams JE, Ellis DS, Muntané MJ, Nadal C. 1996. Myositis caused by Pleistophora in a patient with AIDS. Med Clin (Barc) 107:779–781. (In Spanish.)
Macher AR, Neafie R, Angritt P, Tuur S. 1988. Microsporidia myositis and the acquired immunodefiency syndrome (AIDS): a four year followup. Ann Intern Med 109:343–344.
Cali A, Takvorian PM. 2003. Ultrastructure and development of Pleistophora ronneafiei n. sp., a microsporidium (Protista) in the skeletal muscle of an immune-compromised individual. J Eukaryot Microbiol 50:77–85.
Connors WJ, Carson JA, Chan WW, Parkins MD. 2017. Albendazole-responsive disseminated Tubulinosema acridophagus in a patient with chronic lymphocytic leukaemia. Clin Microbiol Infect 23:684–685.
Cali A, Meisler D, Lowder C, Lembach R, Ayers L, Takvorian P, Rutherford I, Longworth D, McMahon J, Bryan R. 1991. Corneal microsporidioses: characterization and identification. J Protozool 38:215S–217S.
Silveira H, Canning EU. 1995. In vitro cultivation of the human microsporidium Vittaforma corneae: development and effect of albendazole. Folia Parasitol (Praha) 42:241–250.
Garcia LS. 2002. Laboratory identification of the microsporidia. J Clin Microbiol 40:1892–1901.
Beckers PJ, Derks GJ, Gool T, Rietveld FJ, Sauerwein RW. 1996. Encephalocytozoon intestinalis-specific monoclonal antibodies for laboratory diagnosis of microsporidiosis. J Clin Microbiol 34:282–285.
Conteas C, Donovan J, Berlin O, Sowerby T, La RM. 1997. Comparison of fluorescence and standard light microscopy for diagnosis of microsporidia in stools of patients with AIDS and chronic diarrhoea. AIDS 11:386.
Weber R, Bryan RT, Owen RL, Wilcox CM, Gorelkin L, Visvesvara GS, The Enteric Opportunistic Infections Working Group. 1992. Improved light-microscopical detection of microsporidia spores in stool and duodenal aspirates. N Engl J Med 326:161–166.
Ryan NJ, Sutherland G, Coughlan K, Globan M, Doultree J, Marshall J, Baird RW, Pedersen J, Dwyer B. 1993. A new trichrome-blue stain for detection of microsporidial species in urine, stool, and nasopharyngeal specimens. J Clin Microbiol 31:3264–3269.
Kokoskin E, Gyorkos TW, Camus A, Cedilotte L, Purtill T, Ward B. 1994. Modified technique for efficient detection of microsporidia. J Clin Microbiol 32:1074–1075.
Moura H, Schwartz DA, Bornay-Llinares F, Sodre FC, Wallace S, Vivesvara GS. 1997. A new and improved “quick-hot gram-chromotrope” technique that differentially stains microsporidian spores in clinical samples, including paraffin-embedded tissue sections. Arch Pathol Lab Med 121:888–893.
Weber R, Schwartz DA, Deplazes P. 1999. Laboratory diagnosis of microsporidiosis, p 315–362. In Wittner M, Weiss LM (ed), The microsporidia and microsporidiosis. ASM Press, Washington, DC.
van Gool T, Snijders F, Reiss P, Eeftinck Schattenkerk JK, van den Bergh Weerman MA, Bartelsman JF, Bruins JJ, Canning EU, Dankert J. 1993. Diagnosis of intestinal and disseminated microsporidial infections in patients with HIV by a new rapid fluorescence technique. J Clin Pathol 46:694–699.
Didier ES, Orenstein JM, Aldras A, Bertucci D, Rogers LB, Janney FA. 1995. Comparison of three staining methods for detecting microsporidia in fluids. J Clin Microbiol 33:3138–3145.
DeGirolami PC, Ezratty CR, Desai G, McCullough A, Asmuth D, Wanke C, Federman M. 1995. Diagnosis of intestinal microsporidiosis by examination of stool and duodenal aspirate with Weber's modified trichrome and Uvitex 2B strains. J Clin Microbiol 33:805–810.
Peterson TS, Spitsbergen JM, Feist SW, Kent ML. 2011. Luna stain, an improved selective stain for detection of microsporidian spores in histologic sections. Dis Aquat Org 95:175–180.
Sheoran AS, Feng X, Singh I, Chapman-Bonofiglio S, Kitaka S, Hanawalt J, Nunnari J, Mansfield K, Tumwine JK, Tzipori S. 2005. Monoclonal antibodies against Enterocytozoon bieneusi of human origin. Clin Diagn Lab Immunol 12:1109–1113.
Singh I, Sheoran AS, Zhang Q, Carville A, Tzipori S. 2005. Sensitivity and specificity of a monoclonal antibody-based fluorescence assay for detecting Enterocytozoon bieneusi spores in feces of simian immunodeficiency virus-infected macaques. Clin Diagn Lab Immunol 12:1141–1144.
Thellier M, Breton J. 2008. Enterocytozoon bieneusi in human and animals, focus on laboratory identification and molecular epidemiology. Parasite 15:349–358.
Procop GW. 2007. Molecular diagnostics for the detection and characterization of microbial pathogens. Clin Infect Dis 45:S99–S111.
Ghosh K, Weiss LM. 2009. Molecular diagnostic tests for microsporidia. Interdiscip Perspect Infect Dis 2009:926521.
Velasquez JN, Carnevale S, Labbe JH, Chertcoff A, Cabrera MG, Oelemann W. 1999. In situ hybridization: a molecular approach for the diagnosis of the microsporidian parasite Enterocytozoon bieneusi. Human Pathol 30:54–58.
Fedorko DP, Hijazi YM. 1996. Application of molecular techniques to the diagnosis of microsporidial infection. Emerg Infect Dis 2:183.
Katzwinkel-Wladarsch S, Deplazes P, Weber R, Loescher T, Rinder H. 1997. Comparison of polymerase chain reaction with light microscopy for detection of microsporidia in clinical specimens. Eur J Clin Microbiol Infect Dis 16:7–10.
Fedorko DP, Nelson NA, Cartwright CP. 1995. Identification of microsporidia in stool specimens by using PCR and restriction endonucleases. J Clin Microbiol 33:1739–1741.
Ombrouck C, Ciceron L, Biligui S, Brown S, Marechal P, van Gool T, Datry A, Danis M, Desportes-Livage I. 1997. Specific PCR assay for direct detection of intestinal microsporidia Enterocytozoon bieneusi and Encephalitozoon intestinalis in fecal specimens from human immunodeficiency virus-infected patients. J Clin Microbiol 35:652–655.
Müller A, Stellermann K, Hartmann P, Schrappe M, Fätkenheuer G, Salzberger B, Diehl V, Franzen C. 1999. A powerful DNA extraction method and PCR for detection of microsporidia in clinical stool specimens. Clin Diagn Lab Immunol 6:243–246.
Polley SD, Boadi S, Watson J, Curry A, Chiodini PL. 2011. Detection and species identification of microsporidial infections using SYBR Green real-time PCR. J Med Microbiol 60:459–466.
Wolk D, Schneider S, Wengenack N, Sloan L, Rosenblatt J. 2002. Real-time PCR method for detection of Encephalitozoon intestinalis from stool specimens. J Clin Microbiol 40:3922–3928.
Carville A, Mansfield K, Widmer G, Lackner A, Kotler D, Wiest P, Gumbo T, Sarbah S, Tzipori S. 1997. Development and application of genetic probes for detection of Enterocytozoon bieneusi in formalin-fixed stools and in intestinal biopsy specimens from infected patients. Clin Diagn Lab Immunol 4:405–408.
Hester JD, Alan Lindquist HD, Bobst AM, Schaefer FW. 2000. Fluorescent in situ detection of Encephalitozoon hellem spores with a 6‐carboxyfluorescein‐labeled ribosomal RNA‐targeted oligonucleotide probe. J Eukaryot Microbiol 47:299–308.
Goguel J, Katlama C, Sarfati C, Maslo C, Leport C, Molina JM. 1997. Remission of AIDS-associated intestinal microsporidiosis with highly active antiretroviral therapy. AIDS 11:1658–1659.
Foudraine NA, Weverling GJ, van Gool T, Roos MT, de Wolf F, Koopmans PP, van den Broek PJ, Meenhorst PL, van Leeuwen R, Lange JM, Reiss P. 1998. Improvement of chronic diarrhoea in patients with advanced HIV-1 infection during potent antiretroviral therapy. AIDS 12:35–41.
Martins SA, Muccioli C, Belfort R, Jr, Castelo A. 2001. Resolution of microsporidial keratoconjunctivitis in an AIDS patient treated with highly active antiretroviral therapy. Am J Ophthalmol 131:378–379.
Maggi P, Larocca AM, Quarto M, Serio G, Brandonisio O, Angarano G, Pastore G. 2000. Effect of antiretroviral therapy on cryptosporidiosis and microsporidiosis in patients infected with human immunodeficiency virus type 1. Eur J Clin Microbiol Infect Dis 19:213–217.
Miao YM, Awad-El-Kariem FM, Franzen C, Ellis DS, Muller A, Counihan HM, Hayes PJ, Gazzard BG. 2000. Eradication of cryptosporidia and microsporidia following successful antiretroviral therapy. J Acquir Immune Defic Syndr 25:124–129.
Sriaroon C, Mayer CA, Chen L, Accurso C, Greene JN, Vincent AL. 2008. Diffuse intra-abdominal granulomatous seeding as a manifestation of immune reconstitution inflammatory syndrome associated with microsporidiosis in a patient with HIV. AIDS Patient Care STDS 22:611–612.
Costa SF, Weiss LM. 2000. Drug treatment of microsporidiosis. Drug Resist Updat 3:384–399.
Molina JM, Tourneur M, Sarfati C, Chevret S, de Gouvello A, Gobert JG, Balkan S, Derouin F. 2002. Fumagillin treatment of intestinal microsporidiosis. N Engl J Med 346:1963–1969.
Molina J-M, Goguel J, Sarfati C, Chastang C, Desportes-Livage I, Michiels J-F, Maslo C, Katlama C, Cotte L, Leport C, Raffi F. 1997. Potential efficacy of fumagillin in intestinal microsporidiosis due to Enterocytozoon bieneusi in patients with HIV infection: results of a drug screening study. AIDS 11:1603–1610.
Dunand VA, Hammer SM, Rossi R, Poulin M, Albrecht MA, Doweiko JP, DeGirolami PC, Coakley E, Piessens E, Wanke CA. 1997. Parasitic sinusitis and otitis in patients infected with human immunodeficiency virus: report of five cases and review. Clin Infect Dis 25:267–272.
Diesenhouse MC, Wilson LA, Corrent GF, Visvesvara GS, Grossniklaus HE, Bryan RT. 1993. Treatment of microsporidial keratoconjunctivitis with topical fumagillin. Am J Ophthalmol 115:293–298.
Weber R, Sauer B, Spycher MA, Deplazes P, Keller R, Ammann R, Briner J, Luthy R. 1994. Detection of Septata intestinalis in stool specimens and coprodiagnostic monitoring of successful treatment with albendazole. Clin Infect Dis 19:342–345.
Molina JM, Chastang C, Goguel J, Michiels JF, Sarfati C, Desportes-Livage I, Horton J, Derouin F, Modai J. 1998. Albendazole for treatment and prophylaxis of microsporidiosis due to Encephalitozoon intestinalis in patients with AIDS: a randomized double-blind controlled trial. J Infect Dis 177:1373–1377.
Han B, Weiss LM. 2018. Therapeutic targets for the treatment of microsporidiosis in humans. Expert Opin Ther Targets 22:903–915.
Li J, Katiyar SK, Hamelin A, Visvesvara GS, Edlind TD. 1996. Tubulin genes from AIDS-associated microsporidia and implications for phylogeny and benzimidazole sensitivity. Mol Biochem Parasitol 78:289–295.
Katiyar S, Edlind T. 1997. In vitro susceptibilities of the AIDS-associated microsporidian Encephalitozoon intestinalis to albendazole, its sulfoxide metabolite, and 12 additional benzimidazole derivatives. Antimicrob Agents Chemo 41:2729–2732.
Akiyoshi DE, Weiss LM, Feng X, Williams BA, Keeling PJ, Zhang Q, Tzipori S. 2007. Analysis of the beta-tubulin genes from Enterocytozoon bieneusi isolates from a human and rhesus macaque. J Eukaryot Microbiol 54:38–41.
Dieterich DT, Lew EA, Kotler DP, Poles MA, Orenstein JM. 1994. Treatment with albendazole for intestinal disease due to Enterocytozoon bieneusi in patients with AIDS. J Infect Dis 169:178–183.
Higgins M, Kent M, Moran J, Weiss L, Dawe S. 1998. Efficacy of the fumagillin analog TNP-470 for Nucleospora salmonis and Loma salmonae infections in chinook salmon Oncorhynchus tshawytscha. Dis Aquat Org 34:45–49.
Coyle C, Kent M, Tanowitz HB, Wittner M, Weiss LM. 1998. TNP-470 is an effective antimicrosporidial agent. J Infect Dis 177:515–518.
Bukreyeva I, Angoulvant A, Bendib I, Gagnard JC, Bourhis JH, Dargere S, Bonhomme J, Thellier M, Gachot B, Wyplosz B. 2017. Enterocytozoon bieneusi microsporidiosis in stem cell transplant recipients treated with fumagillin. Emerg Infect Dis 23:1039–1041.
Desoubeaux G, Maakaroun-Vermesse Z, Lier C, Bailly E, Morio F, Labarthe F, Bernard L, Chandenier J. 2013. Successful treatment with fumagillin of the first pediatric case of digestive microsporidiosis in a liver-kidney transplant. Transpl Infect Dis 15:E250–E259.
Anwar-Bruni DM, Hogan SE, Schwartz DA, Wilcox CM, Bryan RT, Lennox JL. 1996. Atovaquone is effective treatment for the symptoms of gastrointestinal microsporidiosis in HIV-1-infected patients. AIDS 10:619–623.
Dionisio D, Sterrantino G, Meli M, Trotta M, Milo D, Leoncini F. 1995. Use of furazolidone for the treatment of microsporidiosis due to Enterocytozoon bieneusi in patients with AIDS. Recenti Prog Med 86:394–397.
Coca M, Kim J, Shenoy S, Chévez-Barrios P, Kapur M. 2016. Microsporidial stromal keratitis: successful treatment with topical voriconazole and oral itraconazole. Cureus 8:e934.
Rossi P, Urbani C, Donelli G, Pozio E. 1999. Resolution of microsporidial sinusitis and keratoconjunctivitis by itraconazole treatment. Am J Ophthalmol 127:210–212.
Sridhar MS, Sharma S. 2003. Microsporidial keratoconjunctivitis in a HIV-seronegative patient treated with debridement and oral itraconazole. Am J Ophthalmol 136:745–746.
Didier ES, Maddry JA, Brindley PJ, Stovall ME, Didier PJ. 2005. Therapeutic strategies for human microsporidia infections. Expert Rev Anti Infect Ther 3:419–434.
Bicart-Sée A, Massip P, Linas M-D, Datry A. 2000. Successful treatment with nitazoxanide of Enterocytozoon bieneusi microsporidiosis in a patient with AIDS. Antimicrob Agents Chemother 44:167–168.
Cabello RR, Guerrero LR, García MRM, Cruz AG. 1997. Nitazoxanide for the treatment of intestinal protozoan and helminthic infections in Mexico. Trans R Soc Trop Med Hyg 91:701–703.
Rossignol J, Maisonneuve H. 1984. Nitazoxanide in the treatment of Taenia saginata and Hymenolepis nana infections. Am J Trop Med Hyg 33:511–512.
Sharpstone D, Rowbottom A, Francis N, Tovey G, Ellis D, Barrett M, Gazzard B. 1997. Thalidomide: a novel therapy for microsporidiosis. Gastroenterology 112:1823–1829.
Bacchi CJ, Weiss LM, Lane S, Frydman B, Valasinas A, Reddy V, Sun JS, Marton LJ, Khan IA, Moretto M. 2002. Novel synthetic polyamines are effective in the treatment of experimental microsporidiosis, an opportunistic AIDS-associated infection. Antimicrob Agents Chemother 46:55–61.
Pleshinger J, Weidner E. 1985. The microsporidian spore invasion tube. IV. Discharge activation begins with pH-triggered Ca2+ influx. J Cell Biol 100:1834–1838.
Sobottka I, Bartscht K, Schäfer P, Weitzel T, Schottelius J, Kock N, Laufs R. 2002. In vitro activity of polyoxin D and nikkomycin Z against Encephalitozoon cuniculi. Parasitol Res 88:451–453.
Bigliardi E, Bernuzzi AM, Corona S, Gatti S, Scaglia M, Sacchi L. 2000. In vitro efficacy of nikkomycin Z against the human isolate of the microsporidian species Encephalitozoon hellem. Antimicrob Agents Chemother 44:3012–3016.
Didier ES, Maddry JA, Kwong CD, Green LC, Snowden KF, Shadduk J. 1998. Screening of compounds for antimicrosporidial activity in vitro. Folia Parasitol 45:129–139.
Didier ES, Bowers L, Stovall ME, Kuebler D, Mittleider D, Brindley PJ, Didier PJ. 2005. Antimicrosporidial activity of (fluoro) quinolones in vitro and in vivo. Folia Parasitol 52:173–181.
García-Torres I, Hernández-Alcántara G, Molina-Ortiz D, Caballero-Salazar S, Olivos-García A, Nava G, López-Velázquez G, Enríquez-Flores S. 2018. First characterization of a microsporidial triosephosphate isomerase and the biochemical mechanisms of its inactivation to propose a new druggable target. Sci Rep 8:8591.
Schwartz DA, Bryan RT. 1999. The microsporidial infections: progress in epidemiology and prevention, p 73–98. In Scheld WM, Craig WA, Hughes JM (ed), Emerging Infections 3. ASM Press, Washington, DC.
Shadduck JA, Polley MB. 1978. Some factors influencing the in vitro infectivity and replication of Encephalitozoon cuniculi. J Protozool 25:491–496.
Albrecht H, Sobottka I. 1997. Enterocytozoon bieneusi infection in patients who are not infected with human immunodeficiency virus. Clin Infect Dis 25:344–344.
Weiser J. 1993. Early experiences with microsporidia of man and mammals. Folia Parasitol 40:257–260.
Modigliani R, Bories C, Le Charpentier Y, Salmeron M, Messing B, Galian A, Rambaud J, Lavergne A, Cochand-Priollet B, Desportes I. 1985. Diarrhoea and malabsorption in acquired immune deficiency syndrome: a study of four cases with special emphasis on opportunistic protozoan infestations. Gut 26:179–187.
Orenstein JM. 1991. Microsporidiosis in the acquired immunodeficiency syndrome. J Parasitol 77:843–864.
Sandfort J, Hannemann A, Gelderblom H, Stark K, Owen RL, Ruf B. 1994. Enterocytozoon bieneusi infection in an immunocompetent patient who had acute diarrhea and who was not infected with the human immunodeficiency virus. Clin Infect Dis 19:514–516.
Mohanty A, Mitra S, Das S, Priyadarshini S, Sahu SK. 2020. Clinical profile of bilateral microsporidial keratoconjunctivitis in healthy individuals—a case series with long-term follow-up. Cornea 39:902–908.
Cali A, Takvorian PM. 1999. Developmental morphology and life cycles of the microsporidia, p 85–128. In Wittner M, Weiss LM (ed), The microsporidia and microsporidiosis. ASM Press, Washington, DC.
Kotler DP, Orenstein JM. 1999. Clinical syndromes associated with microsporidia, p 258–292. In Wittner M, Weiss LM (ed), The microsporidia and microsporidiosis. ASM Press, Washington, DC.
Ghosh K, Schwartz D, Weiss LM. 2014. Laboratory diagnosis of microsporidiosis, p 421–456. In Weiss LM, Becnel JJ (ed), Microsporidia: pathogens of opportunity. Wiley Blackwell, Oxford, United Kingdom.
Monaghan SR, Rumney RL, Vo NTK, Bols NC, Lee LEJ. 2011. In vitro growth of microsporidia Anncaliia algerae in cell lines from warm water fish. In Vitro Cell Dev Biol Anim 47:104–113.
Sprague V. 1974. Nosema connori n. sp., a microsporidian parasite of man. Trans Am Microsc Soc 93:400–403.
Vávra J, Bedrník P, Cinátl J. 1972. Isolation and in vitro cultivation of the mammalian microsporidian Encephalitozoon cuniculi. Folia Parasitol (Praha) 19:349–354.
Colbourn NI, Hollister WS, Curry A, Canning EU. 1994. Activity of albendazole against Encephalitozoon cuniculi in vitro. Eur J Protistol 30:211–220.
Ghosh K, Nieves E, Keeling P, Cali A, Weiss LM. 2012. A new vesicular compartment in Encephalitozoon cuniculi. Microbes Infect 14:324–328.
Fasshauer V, Gross U, Bohne W. 2005. The parasitophorous vacuole membrane of Encephalitozoon cuniculi lacks host cell membrane proteins immediately after invasion. Eukaryot Cell 4:221–224.
Joseph J, Sharma S. 2009. In vitro culture of various species of microsporidia causing keratitis: evaluation of three immortalized cell lines. Indian J Med Microbiol 27:35–39.
Shadduck JA. 1969. Nosema cuniculi: in vitro isolation. Science 166:516–517.
Haro M, Del Aguila C, Fenoy S, Henriques-Gil N. 2003. Intraspecies genotype variability of the microsporidian parasite Encephalitozoon hellem. J Clin Microbiol 41:4166–4171.
Haro M, Del Aguila C, Fenoy S, Henriques-Gil N. 2006. Variability in infection efficiency In vitro of different strains of the microsporidian Encephalitozoon hellem. J Eukaryot Microbiol 53:46–48.
Khanduja S, Ghoshal U, Agarwal V, Pant P, Ghoshal UC. 2017. Identification and genotyping of Enterocytozoon bieneusi among human immunodeficiency virus infected patients. J Infect Public Health 10:31–40.
Breton J, Bart-Delabesse E, Biligui S, Carbone A, Seiller X, Okome-Nkoumou M, Nzamba C, Kombila M, Accoceberry I, Thellier M. 2007. New highly divergent rRNA sequence among biodiverse genotypes of Enterocytozoon bieneusi strains isolated from humans in Gabon and Cameroon. J Clin Microbiol 45:2580–2589.
Didier ES. 1997. Effects of albendazole, fumagillin, and TNP-470 on microsporidial replication in vitro. Antimicrob Agents Chemother 41:1541–1546.
Watson AK, Williams TA, Williams BAP, Moore KA, Hirt RP, Embley TM. 2015. Transcriptomic profiling of host-parasite interactions in the microsporidian Trachipleistophora hominis. BMC Genomics 16:983.
Franzen C, Salzberger B. 2008. Analysis of the beta-tubulin gene from Vittaforma corneae suggests benzimidazole resistance. Antimicrob Agents Chemo 52:790–793.
Sokolova YY, Bowers LC, Alvarez X, Didier ES. 2019. Encephalitozoon cuniculi and Vittaforma corneae (Phylum Microsporidia) inhibit staurosporine-induced apoptosis in human THP-1 macrophages in vitro. Parasitology 146:569–579.
Leitch G, Shaw A, Colden-Stanfield M, Scanlon M, Visvesvara G. 2005. Multinucleate host cells induced by Vittaforma corneae (Microsporidia). Folia Parasitol 52:103–110.
Bryan RT, Cali A, Owen RL, Spencer HC. 1991. Microsporidia: opportunistic pathogens in patients with AIDS. Prog Clin Parasitol 2:1–26.
Pinnolis M, Egbert PR, Font RL, Winter FC. 1981. Nosematosis of the cornea. Case report, including electron microscopic studies. Arch Ophthalmol 99:1044–1047.
Ashton N, Wirasinha PA. 1973. Encephalitozoonosis (nosematosis) of the cornea. Br J Ophthalmol 57:669–674.

Author Bios

Department of Pathogenic Biology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
Bing Han, Ph.D., completed his thesis project in Dr. Louis Weiss’ laboratory in the Pathology Department of the Albert Einstein College of Medicine, New York, NY, as a joint student funded by the Chinese Scholarship Council. In 2017, he obtained his Ph.D. from Southwest University, Chongqing, China. He subsequently did a postdoctoral research fellowship in the laboratory of Dr. Weiss, examining the interaction of the polar tube with the host cell during invasion. Dr. Han is currently a Full Professor at the School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China. His research interests include the molecular mechanism(s) of microsporidian host cell invasion and the interaction of host mitochondria with the microsporidian sporoplasm.
Guoqing Pan
State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, China
Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China
Guoqing Pan, Ph.D., is a Full Professor of the State Key Laboratory of Silkworm Genome Biology, Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China. He earned his Ph.D. at Southwest University, Chongqing, China, in 2009. Dr. Pan was trained at the University of California San Diego as a visiting scholar during 2013-2014. Dr. Pan’s current research interests include the genomic biology of Nosema bombycis, a microsporidian pathogen of silkworms, the interaction of microsporidia with host cells, and the evolution of intestinal microorganisms in insects and their interaction with their hosts.
Department of Pathology, Albert Einstein College of Medicine, New York, New York, USA
Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA
Louis M. Weiss, M.D., M.P.H., is Professor of Pathology (Parasitology and Tropical Medicine) and Professor of Medicine (Infectious Diseases), at the Albert Einstein College of Medicine, Bronx, NY. In 1982, he earned his M.D. from the Johns Hopkins University School of Medicine, Baltimore, MD, and his M.P.H. from the Johns Hopkins University School of Public Health. He then completed a residency in internal medicine at the University of Chicago, followed by an Infectious Diseases Fellowship at Montefiore Medical Center-Albert Einstein College of Medicine. Dr. Weiss’ interest in these pathogens started with the recognition of microsporidia as opportunistic pathogens in patients with AIDS. His research on microsporidia over the last 25 years has included studies on diagnostic approaches, microsporidian taxonomy, drug development for the treatment of microsporidiosis, the structure and composition of the polar tube, and the interactions of polar tube proteins with host cell proteins.

Information & Contributors


Published In

cover image Clinical Microbiology Reviews
Clinical Microbiology Reviews
Volume 34Number 415 December 2021
eLocator: e00010-20
PubMed: 34190570


Published online: 30 June 2021


Request permissions for this article.


  1. microsporidia
  2. therapy
  3. diagnostics
  4. prevention
  5. Enterocytozoon
  6. Encephalitozoon
  7. Anncaliia
  8. Vittaforma
  9. AIDS
  10. albendazole
  11. fumagillin



Department of Pathogenic Biology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
Guoqing Pan
State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, China
Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China
Department of Pathology, Albert Einstein College of Medicine, New York, New York, USA
Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA

Metrics & Citations




If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

View Options

Get Access

Non-Member Login
Buy Article
Clinical Microbiology Reviews Vol.34 • Issue 4 • ASM Journals Pay Per View, PPV 25
Journal Subscription
Clinical Microbiology Reviews
ASM members can purchase subscriptions to journals.
Join or renew

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

Full Text

Open Full Text


Open ePub


Download PDF

Figures and Media






Share the article link

Share with email

Share on social media

American Society for Microbiology ("ASM") is committed to maintaining your confidence and trust with respect to the information we collect from you on websites owned and operated by ASM ("ASM Web Sites") and other sources. This Privacy Policy sets forth the information we collect about you, how we use this information and the choices you have about how we use such information.
FIND OUT MORE about the privacy policy