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Infection of the biliary tract with the microsporidium Enterocytozoon (E.) bieneusi may cause some cases of AIDS-related cholangitis. Microsporidia are parasites, and cholangitis is an inflammation of the bile duct, suppressing the flow of bile and causing abdominal pain and fever. Most cases are attributed to infection with cytomegalovirus or cryptosporidia, but in about 40% of the cases of AIDS-related cholangitis there is no identifiable cause. Of eight, HIV-infected homosexual men with unexplained cholangitis, six showed signs of E. bieneusi infection. All eight patients had bile ducts infected with microsporidia. Microsporidial infection of the biliary tract is associated with homosexual behavior and severe immunodeficiency.