{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:05:55Z","timestamp":1792271155236,"version":"4.4.0"},"reference-count":11,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T00:00:00Z","timestamp":1656892800000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,6,10]]},"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:p>A man in his 50s was admitted with 4\u2009months of myalgia, headaches, hypercalcaemia and declining renal function on a background of lung transplantation for cystic fibrosis 5\u2009years prior. MRI confirmed myositis and a muscle biopsy revealed invasive muscular microsporidial infection. Positron emission tomography(PET)\/CT revealed widespread dissemination of the infection. Albendazole was commenced and after a 1\u2009week systemic inflammatory response syndrome, the patient made a significant recovery and was discharged home. PCR testing confirmed the species as <jats:italic>Anncaliia algerae<\/jats:italic>, which is known to infect mosquitoes, larvae and contaminate water supplies. This case highlights the need to relentlessly pursue a diagnosis and to consider atypical pathology in immune compromised patients. A tissue sample yielded highly beneficial and unexpected results. A multispecialty approach was essential given the varied infection manifestations, which included myositis, keratitis and possible central nervous system, vocal cord, parapharyngeal and renal involvement.<\/jats:p>","DOI":"10.1136\/bcr-2022-250643","type":"journal-article","created":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T12:11:42Z","timestamp":1656936702000},"page":"e250643","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Microsporidial myositis, keratitis and hypercalcaemia in a cystic fibrosis lung transplant recipient"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0138-5224","authenticated-orcid":false,"given":"Anna Louise","family":"Watson","sequence":"first","affiliation":[{"name":"General Medicine & Infectious Diseases, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Matic","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Robertson","sequence":"additional","affiliation":[{"name":"Pathology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3266-3250","authenticated-orcid":false,"given":"Alexandra Gabrielle Ann","family":"Stewart","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,7,4]]},"reference":[{"key":"2025082702491433000_15.7.e250643.1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2002.131126"},{"key":"2025082702491433000_15.7.e250643.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032655"},{"key":"2025082702491433000_15.7.e250643.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.fbr.2009.05.001"},{"key":"2025082702491433000_15.7.e250643.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1550-7408.1985.tb03046.x"},{"key":"2025082702491433000_15.7.e250643.5","doi-asserted-by":"publisher","DOI":"10.1097\/01.qco.0000244055.46382.23"},{"key":"2025082702491433000_15.7.e250643.6","doi-asserted-by":"crossref","unstructured":"Fayer R , Santin-Duran M . Epidemiology of microsporidia in human infections. In: Weiss LM , Becnel JJ , eds. Microsporidia: pathogens of opportunity. New York: Academic, 2014. : 135\u201364 p..","DOI":"10.1002\/9781118395264.ch3"},{"key":"2025082702491433000_15.7.e250643.7","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1111\/j.1550-7408.1970.tb02365.x","article-title":"Nosema algerae n. sp. (Cnidospora, Microsporida) a pathogen in a laboratory colony of Anopheles stephensi Liston (Diptera, Culicidae)","volume":"17","author":"Vavra","year":"1970","journal-title":"J Protozool"},{"key":"2025082702491433000_15.7.e250643.8","doi-asserted-by":"publisher","DOI":"10.3201\/eid2002.131126"},{"key":"2025082702491433000_15.7.e250643.9","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofw158"},{"key":"2025082702491433000_15.7.e250643.10","unstructured":"US Centers for Disease Control and Prevention . Rainwater collection. Available: https:\/\/www.cdc.gov\/healthywater\/drinking\/private\/rainwater-collection.html [Accessed 6 Apr 2022]."},{"key":"2025082702491433000_15.7.e250643.11","doi-asserted-by":"crossref","DOI":"10.1128\/microbiolspec.FUNK-0018-2016","article-title":"Microsporidia: obligate intracellular pathogens within the fungal Kingdom","volume":"5","author":"Han","year":"2017","journal-title":"Microbiol Spectr"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-250643","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:49:23Z","timestamp":1756288163000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-250643"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":11,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7,4]]},"published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1136\/bcr-2022-250643"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-250643","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7]]}}}