What is the preferred endoscopic procedure for the evaluation of diarrhea in AIDS? The advantage of endoscopy is that it permits direct visualization of the mucosa and retrieval of tissue for histologic examination. The diagnostic yield of colonoscopy in HIV-infected patients with chronic diarrhea and negative stool studies ranges from 27% to 37%; in patients …
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Clinical features of HSV proctitis in AIDS HSV proctitis is the most common cause of nongonococcal proctitis in sexually active homosexual men. HSV proctitis classically presents with tenesmus, purulent rectal discharge, severe proctalgia, fever, constipation, and anorectal bleeding. Painful inguinal lymphadenopathy is an almost universal finding. The pain tends to distribute in the region of …
What is the approach to diarrhea in HIV infected patients? It is important to consider patient exposures. A history of new medications or an alteration in a current regimen, such as antiretrovirals or antibacterials, is important because many protease inhibitors are associated with diarrhea and antibacterials are associated with Clostridium difficile colitis. In febrile patients, blood cultures …
What is the clinical presentation of diarrhea in AIDS? When evaluating an HIV-infected patient with diarrhea, careful attention should be directed to the history and physical examination. Enteritis (small bowel diarrhea) is associated with voluminous, watery bowel movements, abdominal bloating, cramping, borborygmi, and nausea. Abdominal pain, if present, tends to be periumbilical or diffuse. Abdominal …
What are the most common causes of pancreatitis in HIV infected patients? Several studies have documented chronic and recurrent elevations of serum amylase and lipase in up to 50% of patients with AIDS. The most common medications associated with pancreatitis in AIDS are pentamidine, didanosine (ddI), and zalcitabine (ddC). Protease inhibitors frequently cause hyperlipidemia. Ritonavir …
How is AIDS cholangiopathy best diagnosed? The most common laboratory finding in this syndrome is a markedly elevated alkaline phosphatase, usually more than three times the upper limits of normal. Typically bilirubin is not elevated and rarely exceeds 3 mg/dL, and transaminases are only mildly elevated. Generally, these patients have a dilated bile duct that …
What are the most common causes of AIDS cholangiopathy? How are they diagnosed? A. Cryptosporidium parvum B. Microsporidia Enterocytozoon bieneusi Encephalitozoon intestinalis Encephalocytozoon cuniculi C. CMV D. MAC E. Cyclospora cayetanensis F. Non-Hodgkin’s lymphoma G. Kaposi sarcoma (KS) Despite its infectious origin, medical therapies aiming at the eradication of these organisms have not produced marked improvement in AIDS cholangiopathy. Conversely, treatment with …