Three Cases of Neurologic Syndrome Caused by Donor-Derived Microsporidiosis

Smith, Rachel M.; Muehlenbachs, Atis; Schaenmann, Joanna; Baxi, Sanjiv; Koo, Sophia; Blau, Dianna; Chin-Hong, Peter; Thorner, Anna R.; Kuehnert, Matthew J.; Wheeler, Kristina; Liakos, Alexis; Jackson, Jonathan W.; Benedict, Theresa; da Silva, Alexandre J.; Ritter, Jana M.; Rollin, Dominique; Metcalfe, Maureen; Goldsmith, Cynthia S.; Visvesvara, Govinda S.; Basavaraju, Sridhar V.; Zaki, Sherif

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Three Cases of Neurologic Syndrome Caused by Donor-Derived Microsporidiosis

Supporting Files Public Domain

Mar 2017
By Smith, Rachel M. ; Muehlenbachs, Atis ; Schaenmann, Joanna ; ...

File Language:

English

Details

Alternative Title:

Emerg Infect Dis
Personal Author:

Smith, Rachel M. ; Muehlenbachs, Atis ; Schaenmann, Joanna ; Baxi, Sanjiv ; Koo, Sophia ; Blau, Dianna ; Chin-Hong, Peter ; Thorner, Anna R. ; Kuehnert, Matthew J. ; Wheeler, Kristina ; Liakos, Alexis ; Jackson, Jonathan W. ; Benedict, Theresa ; da Silva, Alexandre J. ; Ritter, Jana M. ; Rollin, Dominique ; Metcalfe, Maureen ; Goldsmith, Cynthia S. ; Visvesvara, Govinda S. ; Basavaraju, Sridhar V. ; Zaki, Sherif
Description:

In April 2014, a kidney transplant recipient in the United States experienced headache, diplopia, and confusion, followed by neurologic decline and death. An investigation to evaluate the possibility of donor-derived infection determined that 3 patients had received 4 organs (kidney, liver, heart/kidney) from the same donor. The liver recipient experienced tremor and gait instability; the heart/kidney and contralateral kidney recipients were hospitalized with encephalitis. None experienced gastrointestinal symptoms. Encephalitozoon cuniculi was detected by tissue PCR in the central nervous system of the deceased kidney recipient and in renal allograft tissue from both kidney recipients. Urine PCR was positive for E. cuniculi in the 2 surviving recipients. Donor serum was positive for E. cuniculi antibodies. E. cuniculi was transmitted to 3 recipients from 1 donor. This rare presentation of disseminated disease resulted in diagnostic delays. Clinicians should consider donor-derived microsporidial infection in organ recipients with unexplained encephalitis, even when gastrointestinal manifestations are absent.
Subjects:

Encephalitis Encephalitozoon Cuniculi Fatal Outcome Female Heart Transplantation Humans Kidney Transplantation Liver Transplantation Male Microsporidiosis Synopsis Tissue Donors
Source:

Emerg Infect Dis. 23(3):387-395.
Pubmed ID:

28220747
Pubmed Central ID:

PMC5382757
Document Type:

Journal Article
Volume:

23
Issue:

3
Collection(s):

Emerging Infectious Diseases
Main Document Checksum:

urn:sha256:6bc98ffb65d08ab87f1f8864477949dba67502bc5c50dc03544b62088f5289ee
Download URL:

https://stacks.cdc.gov/view/cdc/44950/cdc_44950_DS1.pdf
File Type:

[PDF - 2.02 MB ]

File Language:

English

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