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Microsporidia are primitive mitochondria-lacking spore-forming eukaryotic protozoa that infect a wide variety of animals and also humans. Of the five genera (Encephalitozoon, Enterocytozoon, Septata, Nosema and Pleistophora) that cause infections in humans, Enterocytozoon bieneusi, Septata intestinalis, and Encephalitozoon hellem are being increasingly identified in patients with acquired immunodeficiency syndrome (AIDS). E. bieneusi causes gastrointestinal disease, S. intestinalis causes gastrointestinal and disseminated disease, and E. hellem causes ocular as well as disseminated disease. We have established in continuous culture a strain of microsporidia isolated from the urine and throat washings of an Italian AIDS patient and identified it as Encephalitozoon hellem, based on its ultrastructural morphology, antigenic pattern, and polymerase chain reaction-amplified small subunit ribosomal RNA. We believe that this is the first time that a strain of microsporidia has been isolated from the throat washings of a patient with microsporidiosis.

The first documented report of an outbreak of human trichinellosis caused by Trichinella spiralis in Italy is described. Two family groups were involved. The source was wild boar meat products. The principal clinical features were fever (60%), myalgia (50%), and diarrhea (40%). The most useful laboratory indicators were eosinophilia (100%), elevated levels of creatine phosphokinase (CPK) (90%) and other muscle enzymes, parasite-specific IgG titers (100%), and anti-newborn larvae antibodies (30%). The levels of these responses correlated with the number of infective muscle larvae ingested, which was influenced by the length of time the ingested meat was cured. The clinical and biological features observed during human infection with T. spiralis appear to have been different from those reported during two outbreaks due to T. britovi, which occurred in southern Italy. The main distinctions between the two types of infections were a longer duration of parasite-specific IgG, increased CPK levels, and a more severe intestinal symptomatology in T. spiralis-infected patients than in those infected with T. britovi.