HIV diarrhea: Difference between revisions
| Line 21: | Line 21: | ||
CD4<200 | CD4<200 | ||
*M. tuberculosis | *M. tuberculosis | ||
*Histoplasma | *Histoplasma | ||
| Line 30: | Line 28: | ||
*Enteroaggregative Escherichia coli (EAEC) (can also affect immunocompetent children) | *Enteroaggregative Escherichia coli (EAEC) (can also affect immunocompetent children) | ||
*HIV can directly infiltrate bowel wall leading to diarrhea | *HIV can directly infiltrate bowel wall leading to diarrhea | ||
CD4 <100 | |||
*Cryptosporidium parvum (chronic course of illness) | |||
*Mycobacterium avium complex (MAC) - infiltration of bowel assoc with malabsorption | |||
*CMV | |||
*Isospora | |||
*Microsporidium | |||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 20:20, 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
- M. tuberculosis
- Histoplasma
- Cryptococcus
- Lymphoma
- Kaposi
- Enteroaggregative Escherichia coli (EAEC) (can also affect immunocompetent children)
- HIV can directly infiltrate bowel wall leading to diarrhea
CD4 <100
- Cryptosporidium parvum (chronic course of illness)
- Mycobacterium avium complex (MAC) - infiltration of bowel assoc with malabsorption
- CMV
- Isospora
- Microsporidium
Diagnosis
Management
Disposition
See Also
References
UpToDate: "Evaluation of the HIV-infected patient with diarrhea"