Potential presence of microsporidia in clinical faecal specimens from the Isle of Man.

Human-related microsporidia Enterocytozoon bieneusi and Encephalitozoon spp. have emerged as opportunistic infectious agents affecting both immunocompromised and immunocompetent individuals. A pilot study to determine the potential presence of microsporidia in the general population that have attended Nobles’ Hospital in Isle of Man (UK) since January 2018 was performed. Thirty eight faecal samples submitted to the Nobles’ Hospital microbiology lab for routine testing were analysed via microscopy using the Modified Trichrome stain. Encephalitozoon spp. spores were observed in 4 samples, specifically 3 female from a range of ages (24 yr, 65yr and 89 yr old) and one male (69 yr old). These four patients were presented with diarrhoea in a semi-liquid/liquid form. Other symptoms included vomiting (89 yr old female), abdominal pain (24 yr old female), right flank pain (68 yr old male), dehydration (89 yr old female) and acute kidney injury (89 yr old female). Campylobacter spp. growth was also detected in one sample (65 yr old female). Although preliminary, our results indicate Encephalitozoon spp. were observed in faecal samples from patients in the Isle of Man presenting with diarrhoea, for which further studies will be required to determine the species and the pathogenic involvement of these pathogens in these patients. To our knowledge, this is the first study of the presence of microsporidia in human faecal samples in Isle of Man. A more comprehensive study is needed to determine the occurrence of microsporidia in patients attending with a diarrheic picture to focus attention on the need to include microsporidial diagnosis in their management.