Encephalitozoon cuniculi Microsporidia in Cerebrospinal Fluid from Immunocompetent Patients, Czech Republic

Abstract

We retrospectively analyzed of 211 frozen cerebrospinal fluid samples from immunocompetent persons in the Czech Republic and detected 6 Encephalitozoon cuniculi-positive samples. Microsporidiosis is generally underestimated and patients are not usually tested for microsporidia, but latent infection in immunodeficient and immunocompetent patients can cause serious complications if not detected and treated.

Keywords: Czech Republic; Encephalitozoon cuniculi; PCR; cerebrospinal fluid; latent infection; parasites; qPCR; zoonoses.

Figure 1

Phylogenetic analysis of Encephalitozoon cuniculi genotypes recovered from cerebrospinal fluid of immunocompetent patients, Czech Republic. Bold indicates sequences obtained in this study, identified by patient number. Sequences for comparisons were obtained from GenBank; accession numbers are in brackets. Tree was constructed by using the maximum-likelihood method. Partial sequences of 16S rRNA gene, the entire internal transcribed spacer region, and a partial sequence of 5.8S rRNA gene were inferred by using neighbor-joining analyses, and relationships were computed by using the Tamura 3-parameter method with gamma distribution and parametric bootstrap analysis of 1,000 replicates in MEGA X software (MEGA, https://www.megasoftware.net). Scale bar indicates nucleotide substitutions per site.

Figure 2

Microscopic examination Encephalitozoon cuniculi­–positive cerebrospinal fluid from immunocompetent patients, Czech Republic. Microsporidial spores (arrows) were stained with Calcofluor M2R and viewed in 490 nm. A) Patient no. 139; B) patient no. 185. Scale bar indicates 10 µm.