The Brief Case: Disseminated Microsporidiosis with Intestinal Cryptosporidium Coinfection in a Patient with Kaposi’s Sarcoma and Castleman Disease Presenting with Acute Kidney Injury

May 19, 2021
Infectious Disease
Apeksha N Agarwal, Wun-Ju Shieh, Cynthia S Goldsmith, Yvonne Qvarnstrom, Yanli Ding, Steven D Dallas, Daniel D Mais
Pathogen:Encephalitozoon intestinalis
Infection Type:Disseminated infection
Pathogen Type:Parasite

Summary

A patient with Kaposi’s Sarcoma and Castleman disease presented with acute kidney injury, revealing a complex disseminated infection. Diagnostic workup identified disseminated microsporidiosis, specifically Encephalitozoon intestinalis, alongside an intestinal Cryptosporidium coinfection. The diagnosis relied on electron microscopy and PCR testing of tissue samples, highlighting the challenges in identifying these opportunistic pathogens in immunocompromised individuals. The patient's underlying conditions likely contributed to the severe, multi-organ involvement. This case underscores the importance of considering atypical opportunistic infections in patients with compromised immune systems, even when initial tests are inconclusive, and utilizing advanced diagnostic techniques for definitive identification.

Key note: Advanced diagnostic methods like electron microscopy and PCR are crucial for identifying disseminated opportunistic infections in immunocompromised patients.

DOI: 10.1046/j.1365