Anncaliia algerae
Louis M. Weiss 1,2,
* and Peter M. Takvorian 3
1
Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA
2
Department of Medicine Division of Infectious Diseases, Albert Einstein College of Medicine, Bronx, NY, USA
3
Department of Biological Sciences, Rutgers University, Newark, NJ, USA
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Anncaliia algerae belongs to the microsporidia, a group of obligate intracellular pathogens originally classified as early
branching 'primitive' protozoa but now understood to be related to the Cryptomycota as a basal branch in the fungal
kingdom. A. algerae has emerged as a rare opportunistic human pathogen in immune compromised patients such as
those taking immune suppressive medications for arthritis, hematologic malignancy, or organ transplantation. It was
originally identified as a pathogen of mosquitoes and is probably transmitted to humans by food or water through
ingestion, inhalation, or contamination of ocular tissue or wounds with environmental spores. A. algerae infection
primarily causes myositis; however, vocal cord, skin, corneal (in immune competent hosts), and disseminated
infections have been reported. Human infection has also been reported with other members of the Anncaliia
genus: Anncaliia vesicularum in a HIV patient, and Anncaliia connori in an infant with thymic dysplasia.
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KEY FACTS:
A. algerae was previously called Nosema
algerae and then Brachiola algerae
before being reclassified to Anncaliia.
A. algerae can be grown in vitro in either
mammalian or insect cells.
The genome sequences for human
(ATCC PRA 109) and insect (ATCC
PRA339, also called Undeen) isolates
are available. The genome contains a
large number of transposable elements
and long terminal repeat (LTR)
retrotransposons.
It has a worldwide distribution and is a
pathogen of mosquitoes and other insects.
DISEASE FACTS:
Most cases have occurred in immune
suppressed patients who either received
immune modulating antibodies for
arthritis or immune suppressive drugs for
organ transplantation.
Myositis may be associated with central
nervous system or cardiac involvement.
Infection is diagnosed by finding spores
and other developmental forms in tissue.
PCR based on the SSU-rRNA gene can
also be used for diagnosis.
Management of A. algerae infection
usually requires minimizing
immunosuppression.
Albendazole has in vitro efficacy and has
resulted in clinical improvement in several
cases. The A. algerae tubulin sequence
has amino acids associated with
sensitivity to albendazole. The addition of
fumagillin to albendazole has been needed
for successful therapy in some cases.
TAXONOMY AND CLASSIFICATION:
PHYLUM: Microsporidia
CLASS: Microsporea
ORDER: Microsporidia
SUPERFAMILY: Tubulinosematoidea
FAMILY: Tubulinosematidae
GENUS: Anncaliia
SPECIES: A. algerae
*Correspondence:
louis.weiss@einsteinmed.org (L.M. Weiss).
762 Trends in Parasitology, August 2021, Vol. 37, No. 8 © 2021 Elsevier Ltd. All rights reserved. https://doi.org/10.1016/j.pt.2021.04.003
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Acknowledgments
Supported by National Institutes of Health (NIH) National Institute of Allergy and Infectious Diseases (NIAID) grant RO1 AI124753 (L.M.W.).
Declaration of interests
The authors declare no competing interests.
Resources
https://microsporidiadb.org/micro/app
www.ATCC.org
https://onlinelibrary.wiley.com/doi/book/10.1002/9781118395264
Literature
1. Anderson, N.W. et al. (2019) A fatal case of disseminated microsporidiosis due to Anncaliia algerae in a renal and pancreas allograft recipient. Open Forum Infect. Dis. 6,
ofz285
2. Boileau, M. et al. (2016) Successful treatment of disseminated Anncaliia algerae microsporidial infection with combination fumagillin and albendazole. Open Forum Infect.
Dis. 3, ofw158
3. Cali, A. et al. (2010) Human vocal cord infection with the microsporidium Anncaliia algerae. J. Eukaryot. Microbiol. 57, 562–567
4. Cali, A. et al. (1998) Brachiola vesicularum, n. g., n. sp., a new microsporidium associated with AIDS and myositis. J. Eukaryot. Microbiol. 45, 240–251
5. Coyle, C.M. et al. (2004) Fatal myositis due to the microsporidian Brachiola algerae, a mosquito pathogen. N. Engl. J. Med. 351, 42–47
6. Field, A.S. et al. (2012) Myositis due to the microsporidian Anncaliia (Brachiola) algerae in a lung transplant recipient. Transpl. Infect. Dis. 14, 169–176
7. Franzen, C. et al. (2006) Transfer of the members of the genus Brachiola (microsporidia) to the genus Anncaliia based on ultrastructural and molecular data. J. Eukaryot.
Microbiol. 53, 26–35
8. Santiana, M. et al. (2014) Analysis of the beta-tubulin gene and morphological changes of the microsporidium Anncaliia algerae both suggest albendazole sensitivity.
J. Eukaryot. Microbiol. 62, 60–68
9. Sutrave, G. et al. (2018) Anncaliia algerae microsporidial myositis, New South Wales, Australia. Emerg. Infect. Dis. 24, 1528–1531
10. Watts, M.R. et al. (2014) Anncaliia algerae microsporidial myositis. Emerg. Infect. Dis. 20, 185–191
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