微孢子蟲病

微孢子蟲病
	微孢子蟲病的感染途徑
症状	腹瀉等
肇因	微孢子蟲感染
风险因子	免疫缺乏者
診斷方法	顯微鏡觀察
藥物	烟曲霉素（英语：Fumagillin）、阿苯達唑
分类和外部资源
醫學專科	傳染病學
ICD-11	1F58
ICD-9-CM	117.9
DiseasesDB	31870
MedlinePlus	221631
eMedicine	221631
Orphanet	2552
	[编辑此条目的维基数据]

微孢子蟲病（Microsporidiosis）是微孢子蟲對人或其他哺乳類造成的感染。微孢子蟲是一類單細胞真菌^[1]，為細胞內寄生物^[2]，過去曾被認為是原生生物，現已被確定為真菌。已知至少有15種（共9個屬）的微孢子蟲可感染人類，其中以比氏肠细胞虫（英语：Enterocytozoon bieneusi）為大宗，其次為腦炎微孢子蟲屬（西班牙语：Encephalitozoon）物種（肠脑炎微孢子虫（英语：Encephalitozoon intestinalis）與兔腦炎微孢子蟲（英语：Encephalitozoon cuniculi）），另外尚有Anncaliia（英语：Anncaliia）、Trachipleistophora、Nosema（英语：Nosema (microsporidian)）、Pleistophora等屬的物種可能造成感染^[3]^[4]。微孢子蟲主要感染愛滋病患等免疫缺乏者，但少數情況下也能感染免疫正常者，症狀因感染物種與途徑而異，感染免疫缺乏者的症狀包括腸道、眼睛、肌肉或全身性的感染，若瀰漫至全身則可能致死^[3]；感染免疫正常者的症狀則大多為自限性的腹瀉^[5]。

微孢子蟲可透過吸入孢子、受污染的食物或飲水、接觸野生動物、糞口傳染、傷口感染或性行為等數種途徑感染人類，在其他動物中可發生垂直傳染（英语：Vertically transmitted infection），在人類中則尚無觀察到此途徑^[5]。此病的初步診斷可以顯微鏡觀察病人組織或糞便樣本判斷，微孢子蟲的孢子呈革蘭氏染色陽性且可抗酸。確切診斷需使用電子顯微鏡或免疫螢光染色（英语：Immunofluorescence）^[6]，判斷具體致病的物種則需使用PCR^[7]^[8]。此病可使用烟曲霉素（英语：Fumagillin）或阿苯達唑治療^[9]^[10]。

研究歷史

早在1924年就有學者提出微孢子蟲可能可感染人類^[11]，但在1980年代愛滋病出現以前僅有零星人類感染個案報導，1927年與1937年分別有一例疑似感染病例，首例確診者是1959年日本一名被腦炎微孢子蟲感染的9歲男童^[5]。兔腦炎微孢子蟲感染實驗動物的案例則偶爾出現^[8]。隨後微孢子蟲病病例隨愛滋病疫情擴散而漸增^[5]，在許多地區為新興病原，感染對象包括兒童、老人、接受器官移植者、愛滋病患者、糖尿病患者和旅行者等^[11]。

症狀

比氏肠细胞虫（英语：Enterocytozoon bieneusi）感染免疫缺乏者時會造成持續性腹瀉、腹痛與體重減輕，在少數案例中感染肺或膽管；感染免疫健全者（一般為旅行者）時則造成為期一月左右的自限性腹瀉^[8]。腦炎微孢子蟲屬（西班牙语：Encephalitozoon）的微孢子蟲感染免疫缺乏者時初期亦造成腹瀉，但後期會擴散而導致全身感染（比氏肠细胞虫則少有此情況）^[8]。

參考文獻

^ Microsporidiosis: Parasitic Infections: Merck Manual Home Health Handbook.
^ Didier ES, Maddry JA, Brindley PJ, Stovall ME, Didier PJ. Therapeutic strategies for human microsporidia infections. Expert Rev Anti Infect Ther. 2005 Jun;3(3):419-34. doi: 10.1586/14787210.3.3.419. PMID 15954858.
^ ^3.0 ^3.1 CDC - DPDx - Microsporidiosis. www.cdc.gov. 2017-12-29 [2018-01-04].
^ Lanternier F, Boutboul D, Menotti J, et al. Microsporidiosis in solid organ transplant recipients: two Enterocytozoon bieneusi cases and review. Transpl Infect Dis. February 2009, 11 (1): 83–8. PMID 18803616. S2CID 205423324. doi:10.1111/j.1399-3062.2008.00347.x.
^ ^5.0 ^5.1 ^5.2 ^5.3 Han, Bing; Pan, Guoqing; Weiss, Louis M. Microsporidiosis in Humans. Clinical Microbiology Reviews. 2021-12-15, 34 (4). doi:10.1128/CMR.00010-20.
^ Weber, R; Bryan, R T; Schwartz, D A; Owen, R L. Human microsporidial infections. Clinical Microbiology Reviews. 1994-10, 7 (4): 426–461. doi:10.1128/cmr.7.4.426.
^ Kock, N. P.; Petersen, H.; Fenner, T.; Sobottka, I.; Schmetz, C.; Deplazes, P.; Pieniazek, N. J.; Albrecht, H.; Schottelius, J. Species-specific identification of microsporidia in stool and intestinal biopsy specimens by the polymerase chain reaction. European Journal of Clinical Microbiology & Infectious Diseases. 1997-05, 16 (5): 369–376. doi:10.1007/BF01726365.
^ ^8.0 ^8.1 ^8.2 ^8.3 Didier, Elizabeth S. Microsporidiosis: An emerging and opportunistic infection in humans and animals. Acta Tropica. 2005-04, 94 (1): 61–76. doi:10.1016/j.actatropica.2005.01.010.
^ Molina JM, Tourneur M, Sarfati C, et al. Fumagillin treatment of intestinal microsporidiosis. N. Engl. J. Med. June 2002, 346 (25): 1963–9. PMID 12075057. doi:10.1056/NEJMoa012924 .
^ Didier ES, Maddry JA, Brindley PJ, Stovall ME, Didier PJ. Therapeutic strategies for human microsporidia infections. Expert Rev Anti Infect Ther. June 2005, 3 (3): 419–34. PMID 15954858. S2CID 42354627. doi:10.1586/14787210.3.3.419.
^ ^11.0 ^11.1 Araniy Fadhilah; Aishah Gabbar; Abdullah A. Bokhari. Microsporidium. StatPearls. 2023.

[urlMicrosporidiosis:_Parasitic_Infections:_Merck_Manual_Home_Health_Handbook-1] Microsporidiosis: Parasitic Infections: Merck Manual Home Health Handbook.

[2] Didier ES, Maddry JA, Brindley PJ, Stovall ME, Didier PJ. Therapeutic strategies for human microsporidia infections. Expert Rev Anti Infect Ther. 2005 Jun;3(3):419-34. doi: 10.1586/14787210.3.3.419. PMID 15954858.

[cdc-3] 3.0 ^3.1 CDC - DPDx - Microsporidiosis. www.cdc.gov. 2017-12-29 [2018-01-04].

[pmid18803616-4] Lanternier F, Boutboul D, Menotti J, et al. Microsporidiosis in solid organ transplant recipients: two Enterocytozoon bieneusi cases and review. Transpl Infect Dis. February 2009, 11 (1): 83–8. PMID 18803616. S2CID 205423324. doi:10.1111/j.1399-3062.2008.00347.x.

[Han2021-5] 5.0 ^5.1 ^5.2 ^5.3 Han, Bing; Pan, Guoqing; Weiss, Louis M. Microsporidiosis in Humans. Clinical Microbiology Reviews. 2021-12-15, 34 (4). doi:10.1128/CMR.00010-20.

[6] Weber, R; Bryan, R T; Schwartz, D A; Owen, R L. Human microsporidial infections. Clinical Microbiology Reviews. 1994-10, 7 (4): 426–461. doi:10.1128/cmr.7.4.426.

[7] Kock, N. P.; Petersen, H.; Fenner, T.; Sobottka, I.; Schmetz, C.; Deplazes, P.; Pieniazek, N. J.; Albrecht, H.; Schottelius, J. Species-specific identification of microsporidia in stool and intestinal biopsy specimens by the polymerase chain reaction. European Journal of Clinical Microbiology & Infectious Diseases. 1997-05, 16 (5): 369–376. doi:10.1007/BF01726365.

[Didier-8] 8.0 ^8.1 ^8.2 ^8.3 Didier, Elizabeth S. Microsporidiosis: An emerging and opportunistic infection in humans and animals. Acta Tropica. 2005-04, 94 (1): 61–76. doi:10.1016/j.actatropica.2005.01.010.

[pmid12075057-9] Molina JM, Tourneur M, Sarfati C, et al. Fumagillin treatment of intestinal microsporidiosis. N. Engl. J. Med. June 2002, 346 (25): 1963–9. PMID 12075057. doi:10.1056/NEJMoa012924 .

[pmid15954858-10] Didier ES, Maddry JA, Brindley PJ, Stovall ME, Didier PJ. Therapeutic strategies for human microsporidia infections. Expert Rev Anti Infect Ther. June 2005, 3 (3): 419–34. PMID 15954858. S2CID 42354627. doi:10.1586/14787210.3.3.419.

[Fadhilah2023-11] 11.0 ^11.1 Araniy Fadhilah; Aishah Gabbar; Abdullah A. Bokhari. Microsporidium. StatPearls. 2023.

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