Diagnosis of human microsporidiosis

Diagnosis of microsporidia depends upon detecting the organism in patient specimens by microscopic or, more recently, by molecular biology methods (Weber et al. 1999; Weiss and Vossbrinck 1999). Histochemical methods such as modified trichrome staining (Weber et al. 1992) and chitinstaining fluorochromes (Van Gool et al. 1993) are simple and useful light microscopic techniques for detection of microsporidia. However, they do not allow for species differentiation which is becoming increasingly important for the therapy. For instance E. intestinalis can be cured by albendazole therapy, but to patients infected with E. bieneusi that will be of little benefit (Van Gool and Dunkert 1995). Transmission electron microscopy is the standard method for identification of microsporidia at species level. However, this is a laborious procedure which needs specialized equipment as well as experience, and it is of limited use for routine diagnostic purposes. Polymerase chain reaction (PCR) with specific primers is more convenient for detection and identification of microsporidia at species level in patient specimens. Screening for microsporidia by histochemical methods, followed by confirmation and identification using PCR may become the model for the laboratory diagnosis of microsporidiosis (Franzen and Müller 1999).

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