[Systemic microsporidiosis and toxoplasmosis in a patient with T prolymphocytic leukemia]

Med Mal Infect. 2009 Jun;39(6):406-8. doi: 10.1016/j.medmal.2008.10.018. Epub 2008 Nov 28.
[Article in French]

Abstract

We report a case of microsporidiosis in a 72-year-old woman presenting with prolymphocytic leukemia. The underlying conditions 7 months after leukemia was diagnosed were pancytopenia and immunosuppression due to alemtuzumab and pentostatin. The patient's status had worsened and she presented with dysuria. Urine cultures for bacteria were repeatedly negative. She was first empirically treated with broad-spectrum antibiotics. Three months later, urinary symptoms were persisting. Her blood lymphocyte count was 90/microl. Urine examination was positive for microsporidia using modified trichrome staining and Uvitex 2B fluorescence. Microsporidia were also detected in stools. The patient was cured by albendazole. This was consistent with an infection due to Encephalitozoon sp. Concurrently, disseminated toxoplasmosis was diagnosed. Toxoplasma gondii was detected in bone marrow, broncho-alveolar lavage and cerebrospinal fluid. She was successfully treated with sulfadiazine-pyrimethamine. Four cases of microsporidiosis in myeloid leukemic patients have been already described. The present case in a patient with lymphoid leukemia is the first to be reported.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Albendazole / therapeutic use
  • Animals
  • Bone Marrow / parasitology
  • Encephalitozoon / isolation & purification
  • Encephalitozoonosis / complications*
  • Encephalitozoonosis / drug therapy
  • Feces / microbiology
  • Female
  • Humans
  • Leukemia, Prolymphocytic, T-Cell / complications*
  • Leukemia, Prolymphocytic, T-Cell / microbiology
  • Toxoplasma / isolation & purification
  • Toxoplasmosis / complications
  • Toxoplasmosis / drug therapy

Substances

  • Albendazole