Mikrosporidiosen des Menschen: Parasitologie, Klinik, Therapie

Zusammenfassung

Mikrosporidien sind obligat intrazelluläre, opportunistische Protozoen, die bei Immunsupprimierten wie z. B. AIDS-Patienten oder Patienten nach Organtransplantation aber auch bei immunkompetenten Personen wie Reisenden aus subtropischen und tropischen Gebieten verschiedene Krankheitsbilder hervorrufen können. Der überwiegende Teil der Mikrosporidiosen in Deutschland sind gastrointestinale Manifestationen bei AIDS-Patienten wie Durchfälle oder Cholangitiden hervorgerufen durch Enterocytozoon bieneusi oder Encephalitozoon intestinalis. Da Enterocytozoon bieneusi und Encephalitozoon intestinalis einen teilweise unterschiedlichen Organtropismus aufweisen und auch unterschiedlich gut therapierbar sind, sollten diese Erreger bei den entsprechenden Risikogruppen nicht nur nachgewiesen sondern auch differenziert werden. Nachweis und Differenzierung können mit Spezialfärbungen, elektronenmikroskopisch und mit molekularbiologischen Methoden erfolgen.

Summary

Microsporidia are obligate intracellular opportunistic parasites that are capable to cause significant morbidity in immunocompromised patients with AIDS as well as in transplant recipients and immunocompetent persons as travellers from tropics and subtropic areas. The majority of microsporidian infections in Germany are gastrointestinal manifestations such as diarrhea or cholangitis due to Enterocytozoon bieneusi or Encephalitozoon intestinalis. These pathogens tend to infect various organ systems and therapeutic options depend on microsporidian species. Thus the most prevalent microsporidia should not only be detected but also be idientified to species level that can be performed by special stainings, by electron microscopy and by molecular-based methods.

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