Microsporidiosis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Laboratory findings consistent with the diagnosis of microsporidiosis include microscopic identification of the organism in fecal smears, positive PCR, and positive serology.

Lab findings

Microscopic identification of the organism

• Identification of the organism in the stool specimens is a quick and cheap method for diagnosis.
• Special stains must be used because spores are not visible with ordinary stains.
• Using chromotrope 2R method, spores appear pink with belt like stripes in the middle of the spores.
• Chromotrope 2R staining technique takes about 90 minutes.
• Using Quick hot gram chromotrope, organism appears dark violet and the belt-like stripes are enhanced.
• Quick hot gram provides better visualization of the organism and cuts down the time needed for staining to 10 minutes.
• Enterocytozoon bieneusi spores measure 0.8 - 1.4 mcm while Anncaliia algerae, Encephalitozoon spp., Vittaforma corneae, and Nosema spp spores measure 1.5 - 4 mcm.
• Fecal smears shows no WBCs nor blood unless concamitant infection is present.

Unidentified microsporidia stained with Chromotrope 2R	Ebieneusi spores chromo2012	Ecuniculi spores gramchromo 2012

Serologic assays:

• IgM or IgG anti microsporidial antibodies can be detected in serum using indirect immunofluorescence assays.

Ehellem spores IFA 2012

PCR

• Molecular identification of Enterocytozoon bieneusi, Encephalitozoon intestinalis, Encephalitozoon hellem and Encephalitozoon cuniculi using PCR is available.
• PCR is the most sensitive and specific method for diagnosing microsporidiosis yet it is expensive and not recommended for routine diagnosis.