HIV diarrhea: Difference between revisions
| Line 23: | Line 23: | ||
*Cryptosporidium parvum (chronic course of illness) | *Cryptosporidium parvum (chronic course of illness) | ||
*Mycobacterium avium complex (MAC) - infiltration of bowel assoc with malabsorption | *Mycobacterium avium complex (MAC) - infiltration of bowel assoc with malabsorption | ||
*M. tuberculosis | |||
*Histoplasma | |||
*Cryptococcus | |||
*Lymphoma | *Lymphoma | ||
*Kaposi | *Kaposi | ||
Revision as of 20:08, 18 March 2015
Background
- Chronic diarrhea (over 28 days), can be presenting symptom of AIDS, or in countries without HAART
- Less common after introduction of HAART
Clinical Presentation
- Ascertain whether small bowel vs large bowel diarrhea
- Small Bowel
- Diarrhea watery and copius
- Weight loss
- Bloating, gas, cramping
- Vit B12 deficient if terminal illeum involved
- Large Bowel
- Frequent small volume, possibly painful stools
- Small Bowel
Differential Diagnosis
CD4>400
- Consider routine pathogens causing Diarrhea
- Side effect of nelfinavir and ritonavir
- Cryptosporidium parvum (brief course of illness)
CD4<200
- Cryptosporidium parvum (chronic course of illness)
- Mycobacterium avium complex (MAC) - infiltration of bowel assoc with malabsorption
- M. tuberculosis
- Histoplasma
- Cryptococcus
- Lymphoma
- Kaposi
- Enteroaggregative Escherichia coli (EAEC) (can also affect immunocompetent children)
- HIV can directly infiltrate bowel wall leading to diarrhea
Diagnosis
Management
Disposition
See Also
References
UpToDate: "Evaluation of the HIV-infected patient with diarrhea"