Chronic Diarrhoea in the HIV-Positive Patient: Specific Pathogens to Consider (in Addition to Other Causes)

Chronic Diarrhoea in the HIV-Positive Patient: Specific Pathogens to Consider (in Addition to Other Causes: See Chapter 22)

Cause	Clinical features	Diagnosis/treatment
Cryptosporidiosis (Cryptosporidium species)	Subacute onset Associated abdominal pain Severe diarrhoea	Identification of oocysts in stool Seek expert advice on treatment
Cystoisosporiasis (*Cystoisospora belli*)	Incubation period One week Associated fever, abdominal pain, diarrhoea with fatty stools	Identification of oocysts in stool, duodenal aspirate or jejunal biopsy Seek expert advice on treatment
Cytomegalovirus(CMV)	Diarrhoea may be accompanied by systemic illness and hepatitis	Serology and/or blood PCR for CMV; consider large bowel endoscopy and biopsy Seek expert advice on management

Cause

Clinical features

Diagnosis/treatment

Cryptosporidiosis

(Cryptosporidium species)

Subacute onset

Associated abdominal pain

Severe diarrhoea

Identification of oocysts in stool

Seek expert advice on treatment

Cystoisosporiasis

(Cystoisospora belli)

Incubation period One week

Associated fever, abdominal pain, diarrhoea with fatty

stools

Identification of oocysts in

stool, duodenal aspirate or jejunal biopsy

Seek expert advice on treatment

Cytomegalovirus(CMV)

Diarrhoea may be accompanied by systemic illness and hepatitis

Serology and/or blood PCR for CMV; consider large bowel endoscopy and biopsy Seek expert advice on management