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Diarrhea in HIVAka: HIV related Diarrhea

Epidemiology
1. Diarrhea is most common intestinal HIV manifestation
2. Affects 50-90% of HIV patients
Signs
1. Often voluminous Secretory Diarrhea
Causes (Pathogen identified in 85% of advanced patient
1. Cryptosporidium
2. Microsporidia
3. Isospora
4. Mycobacterium Avium Complex (MAC)
5. Salmonella
6. Campylobacter jejuni
7. Cytomegalovirus (CMV) Infection
8. Herpes Simplex Virus (HSV)
  1. Can also cause rectal ulcers and pain
9. Shigella
10. Clostridium
11. Histoplasma capsulatum
12. Pathogen negative (HIV-induced Diarrhea)
  1. Can be chronic and cause severe wasting
  2. Unclear etiology
    1. Possibly due to focal mucosal immune defects
    2. Secondary to CD4 Cell Count depletion
    3. Leads to Bacterial overgrowth
    4. Leads to Mucosal inflammation
Diagnosis
1. Examine multiple stools first
2. Stool exam not diagnostic
  1. Upper and lower endoscopy with biopsies and cultures

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This page was written by Scott Moses, MD. This page was last revised on 3/7/2008 9:21:00 AM. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.