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Causes of chronic diarrhea in patients with AIDS in Thailand: A prospective clinical and microbiological study

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Abstract

A prospective study was designed to investigate the causes of chronic diarrhea in AIDS patients in Thailand. Forty-five patients from Bamrasnaradura Infectious Diseases Hospital were enrolled. Extensive investigations included multiple stool examinations for ova and parasites, using the stool formalin-ether concentration method, stool culture, stool acid-fast bacilli (AFB) stain, stool modified AFB stain, esophago-gastroduoscopy with duodenal aspirate and biopsy, and colonoscopy with biopsy. Biopsied specimens were examined with H&E, Giemsa, Gram, Periodic acid Schiff, and AFB stains. Definitive causes were found in 29 patients (64.4%). Of these 29, 7 patients were found to habor more than 1 pathogen (15.5%). The most commonly found enteric pathogen wasCryptosporidium parvum (20.0%). Less frequently found pathogens wereMycobacterium tuberculosis (17.8%),Salmonella spp. (15.5%),Cytomegalovirus (11.1%),Mycobacterium avium intracellulare (6.6%), Strongyloides stercoralis (4.4%),Giardia lamblia (4.4%),Cryptococcus neoformans (2.2%),Histoplasma capsulatum (2.2%),Campylobacter jejun (2.2%), andCyclospora cayetanensis (2.2%).Salmonella spp., Mycobacterium tuberculosis, andMycobacterium avium intracellulare infections were shown to be more common in Thailand than in African countries.

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References

  1. Colebunders R, Francis H, Mann JM, et al. Persistent diarrhea, strongly associated with HIV infection in Kinshasa, Zaire. Am J Gastroenterol 1987;82:859–864.

    CAS  PubMed  Google Scholar 

  2. Serwadda D, Mugerwa RD, Sewankambo NK, et al. Slim disease: a new disease in Uganda and its association with HTLV-III infection. Lancet 1985;II:849–852.

    Google Scholar 

  3. Page JW, Liautaud B, Thomas F, et al. Characteristics of the acquired immunodeficiency syndrome (AIDS) in Haiti. N Engl J Med 1983;309:945–952.

    Google Scholar 

  4. Rene E, Marche C, Regnier B, et al. Intestinal infections in patients with acquired immunodeficiency syndrome. A prospective study in 132 patients. Dig Dis Sci 1989;34:773–780.

    CAS  PubMed  Google Scholar 

  5. Smith P, Quinn T, Strober W, Janoff E, Masur H. Gastrointestinal infections in AIDS. Ann Intern Med 1992;116:63–77.

    CAS  PubMed  Google Scholar 

  6. Pitlik SD, Fainstein V, Garza D, et al. Human cryptosporidiosis: Spectrum of disease. Report of six cases and review of the literature. Arch Intern Med 1983;143:2269–2275.

    Article  CAS  PubMed  Google Scholar 

  7. Dupont HL. Cryptosporidiosis and healthy host. N Engl J Med 1985;312:1319–1320.

    CAS  PubMed  Google Scholar 

  8. Wolfson JS, Richter JM, Waldron MA, et al. Cryptosporidiosis in immunocompetent patients. N Engl J Med 1985;312:1278–1281.

    CAS  PubMed  Google Scholar 

  9. Lucas SB, Papadaci L, Conlon C, et al. Diagnosis of intestinal microsporidiosis in patients with AIDS. J Clin Pathol 1989; 42:885–890.

    CAS  PubMed  Google Scholar 

  10. Rijpstra AC, Canning EU, Van Ketel RJ, et al. Use of light microscopy to diagnose small-intestinal microsporidiosis in patients with AIDS. J Infect Dis 1988;157:827–831.

    CAS  PubMed  Google Scholar 

  11. Bandall RP, Lucas S, Moody A, Tovey G, Chiodini PL. Diarrhea associated with cyanobacterium-like bodies: A new coccidian enteritis of man. Lancet 1993;341:590–592.

    Google Scholar 

  12. Long EG, White EH, Carmichael WW, et al. Morphologic and staining characteristics of cyanobacterium-like organism associated with diarrhea. J Infect Dis 1991;164:199–202.

    CAS  PubMed  Google Scholar 

  13. Ortega YR, Sterling CR, Gilman RH, Cama VA, Diaz F,Cyclospora species: A new protozoan pathogen of humans. N Engl J Med 1993;328:1308–1312.

    Article  CAS  PubMed  Google Scholar 

  14. Dallabetta GN, Miotti PG. Chronic diarrhea in AIDS patients in the tropics: A review. Tropical Doctor 1992;22:3–9.

    CAS  PubMed  Google Scholar 

  15. Centers for Disease Control. 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. Morb Mortal Wkly Rep 1993;41(RR 17):1–19.

    Google Scholar 

  16. Rabenec L. Diagnostic workup strategies for patients with HIV-related chronic diarrhea. J Clin Gastroenterol 1993;16:245–250.

    Google Scholar 

  17. Sewankambo N, Mugerwa RD, Goodgame R, et al. Enteropathic AIDS in Uganda: An endoscopic, histological and microbiological study. AIDS 1987;1:9–13.

    CAS  PubMed  Google Scholar 

  18. Malebranche R, Amoux E, Guerin JM, et al. Acquired immunodeficiency syndrome with severe gastrointestinal manifestations in Haiti. Lancet 1983;II:873–878.

    Google Scholar 

  19. Colebunders R, Lusakumuni K, Nelson AM, et al. Persistent diarrhea in Zairian AIDS patients: An endoscopic and histological study. Gut 1988;29:1687–1691.

    CAS  PubMed  Google Scholar 

  20. Conlon CP, Pinching AJ, Perera CU, et al. HIV-related enteropathy in Zambia: A clinical, microbiological and histological study. Am J Trop Med Hyg 1990;42:83–87.

    CAS  PubMed  Google Scholar 

  21. Conlon CP, Banda HM, Lou NP, et al. Fecal mycobacteria and their relationship to HIV-related enteritis in Lusaka, Zambia. AIDS 1989;3:539–541.

    CAS  PubMed  Google Scholar 

  22. Sewankambo N, Mugerwa RD, Goodgame R, et al. Enteropathic AIDS in Uganda. An endoscopic, histological and microbiological study. AIDS 1987;1:9–13.

    CAS  PubMed  Google Scholar 

  23. Parente F, Cemuschi M, Antimori S, et al. Severe abdominal pain in patients with AIDS: Frequency, clinical aspects, causes, and outcome. Scand J Gastroenterol 1994;29:511–515.

    CAS  PubMed  Google Scholar 

  24. Whiteside ME, Barkin JS, May RG, et al. Enteric coccidiosis among patients with the acquired immunodeficiency syndrome. Am J Trop Med 1984;33:1065–1072.

    CAS  Google Scholar 

  25. Navin TR, Hardy AM. Cryptosporidiosis in patients with AIDS. J Infect Dis 1987;155:150.

    CAS  PubMed  Google Scholar 

  26. Soave R, Johnson WD.Cryptosporidium andIsospora belli infections. J Infect Dis 1988;157:225–229.

    CAS  PubMed  Google Scholar 

  27. Ma P, Soave R. Three-step examination or cryptospridiosis in ten homosexual men with protracted watery diarrhea. J Infect Dis 1983;147:824–828.

    CAS  PubMed  Google Scholar 

  28. DeHovitz JA, Pape JW, Boncy M, Johnson WD. Clinical manifestations and therapy ofIsospora belli infection in patients with the acquired immunodeficiency syndrome. N Engl J Med 1986;11:87–90.

    Google Scholar 

  29. Shadduck JA. Human microsporidiosis and AIDS. Rev Infect Dis 1989;11:203–207.

    CAS  PubMed  Google Scholar 

  30. Pape JW, Verdier RI, Johnson WD. Treatment and prophylaxis ofIsospora belli infection in patients with the acquired immunodeficiency syndrome. N Engl J Med 1989;320:1044–1047.

    CAS  PubMed  Google Scholar 

  31. Harries AD. Tuberculosis and human immunodeficiency virus infection in developing countries. Lancet 1990;335:387–390.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Siriraj Hospital, Manidol University, 10700, Bangkok, Thailand

    Sathaporn Manatsathit, Somchal Leelakusolwong & Udom Kachintorn

  2. Department of Parasitology, Siriraj Hospital, Manidol University, 10700, Bangkok, Thailand

    Darawan Wanachiwanawin

  3. Department of Pathology, Siriraj Hospital, Manidol University, 10700, Bangkok, Thailand

    Parvinee Suwanagool

  4. Department of Medicine, Bamrasnaradura Infectious Diseases Hospital, 11000, Nonthaburi, Thailand

    Somsit Tansupasawasdikul, Surachai Setawarin, Saranjit Prakasvejakit & Boonchuey Eampokalap

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  1. Sathaporn Manatsathit
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  2. Somsit Tansupasawasdikul
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  5. Parvinee Suwanagool
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Manatsathit, S., Tansupasawasdikul, S., Wanachiwanawin, D. et al. Causes of chronic diarrhea in patients with AIDS in Thailand: A prospective clinical and microbiological study. J Gastroenterol 31, 533–537 (1996). https://doi.org/10.1007/BF02355053

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  • DOI: https://doi.org/10.1007/BF02355053

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