Skip to main content
SpringerLink
Log in

Erregernegative Diarrhö vs. neue Erreger bei HIV-infizierten Patienten

  • Conference paper
Ökosystem Darm VI

  • 44 Accesses

Zusammenfassung

Eines der häufigsten klinischen Probleme bei HIV-infizierten Patienten ist die akute oder chronische Diarrhö; es wurde berichtet, daß in entwickelten Ländern 18–50% der Aids-Patienten über eine Durchfallsproblematik klagen [22, 34, 37, 44], während es in Entwicklungsländern bis zu 90% sein können [28]. In vielen Fällen werden in Zusammehang mit der Diarrhö enterale Infektionserreger nachgewiesen, wobei pathogene oder opportunistische Darmkeime mit unterschiedlicher Häufigkeit vorkommen [38]. Bei einer beachtlichen Anzahl von Patienten kann jedoch trotz intensiver Diagnostik kein Erreger isoliert werden [11]. Die Erklärung dafür kann sein, daß sog. neue Erreger mit bisher noch nicht abschätzbarer klinischer Bedeutung vorkommen, daß das HIV selber über eine mukosale Infektion enteropathogen wirkt, oder aber daß nichtinfektiöse Ursachen zu bedenken sind. Im folgenden soll besonders auf die Bedeutung neuerer Infektionserreger, die im Gastrointestinaltrakt eine Rolle spielen könnten, eingegangen werden.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Bellomo AR, Perlman DC, Kaminsky DL, Brettholz EM, Sarlin JG (1992) Pneumocystis colitis in a patient with the acquired immunodeficiency syndrome. Am J Gastroenterol 87: 759–761

    PubMed  CAS  Google Scholar 

  2. Bendall RP, Lucas S, Moody A, Tovey G, Chiodini PL (1993) Diarrhoea associated with cyanobacterium-like bodies: a new coccidian enteritis of man. Lancet 341: 590–592

    Article  PubMed  CAS  Google Scholar 

  3. Blanshard C, Jackson AM, Shanson DC, Francis N, Gazzard BG (1992) Cryptosporidiosis in HIV-seropositive patients. Q J Med 85: 813–823

    PubMed  CAS  Google Scholar 

  4. Blanshard C, Hollister WS, Peacock CS, Tovey DG, Ellis DS, Canning EU, Gazzard BG (1992) Simultaneous infection with two types of intestinal microsporidia in a patient with Aids. Gut 33: 418–420

    Article  PubMed  CAS  Google Scholar 

  5. Blanshard C, Ellis DS, Tovey DG, Dowell S, Gazzar GB (1992) Treatment of intestinal microsporidiosis with albendazole in patients with Aids. Aids 6: 311–313

    Article  PubMed  CAS  Google Scholar 

  6. Böttger EC, Teske A, Kirschner P, Bost S, Chang HR, Beer V, Hirschel B (1992) Disseminated „Mycobacterium genavense“ infection in patients with Aids. Lancet 340: 76–80

    Article  PubMed  Google Scholar 

  7. Budhraja M, Levendoglu H, Kocka F, Mangkornkanok M, Sherer R (1987) Duodenal muco-sal T cell subpopulation and bacterial cultures in acquired immune deficiency syndrome. Am J Gastroenterol 82: 427–431

    PubMed  CAS  Google Scholar 

  8. Cali A, Kotler DP, Orenstein JM (1993) Septata intestinalis N.G., N. Sp., an intestinal microsporidian associated with chronic diarrhea and dissemination in Aids patients. J Euk Microbiol 40: 101–112

    Google Scholar 

  9. Clarkston WK, Bonacini M, Peterson I (1991) Colitis due to Histoplasma capsulatum in the acquired immune deficiency syndrome. Am J Gastroenterol 86: 913–916

    PubMed  CAS  Google Scholar 

  10. Connolly GM, Dryden MS, Shanson DC, Gazzard BG (1988) Cryptosporidial diarrhoea in Aids and its treatment. Gut 29: 593–597

    Article  PubMed  CAS  Google Scholar 

  11. Connolly GM, Forbes A, Gazzard BG (1990) Investigation of seemingly pathogen-negative diarrhoea in patients infected with HIV1. Gut 31: 886–889

    Article  PubMed  CAS  Google Scholar 

  12. Cruz JR, Bartlett AV, Herrmann JE, Caceres P, Blacklow NR, Cano F (1992) Astrovirus-associated diarrhea among Guatemalan ambulatory rural children. J Clin Microbiol 30: 1140–1144

    PubMed  CAS  Google Scholar 

  13. Cunningham AL, Grohman GS, Harkness J, Law C, Marriott D, Tindall B, Cooper DA (1988) Gastrointestinal viral infections in homosexual men who were symptomatic and seropositive for human immunodeficiency virus. J Infect Dis 158: 386–391

    Article  PubMed  CAS  Google Scholar 

  14. Field AS, Hing MC, Milliken ST, Marriott DJ (1993) Microsporidia in the small intestine of HIV-infected patients. A new diagnostic technique and a new species. Med J Aust 158: 390–394

    Google Scholar 

  15. Flanigan T, Whalen C, Turner J, Soave R, Toerner J, Havlir D, Kotler D (1992) Cryptosporidium infection and CD 4 counts. Ann Int Med 116: 840–842

    PubMed  CAS  Google Scholar 

  16. Genta RM, Chappell CL, White AC, Kimball KT, Goodgame RW (1993) Duodenal morphology and intensity of infection in Aids-related intestinal cryptosporidiosis. Gastroenterol 105: 1769–1775

    CAS  Google Scholar 

  17. Goodgame RW (1993) Gastrointestinal cytomegalovirus disease. Ann Int Med 119: 924–935

    PubMed  CAS  Google Scholar 

  18. Goodgame RW, Genta RM, White AC, Chappell CL (1993) Intensity of infection in Aids-associated cryptosporidiosis. J Infect Dis 167: 704–709

    Article  PubMed  CAS  Google Scholar 

  19. Grohmann GS, Glass RI, Pereira HG, Monroe SS, HightowerAW, Weber R, Bryan RT (1993) Enteric viruses and diarrhaea in HIV-infected patients. N Engl J Med 329: 14–20

    Google Scholar 

  20. Hart AS, Ridinger MT, Soundarajan R, Peters CS, Swiatlo AL, Kocka FE (1990) Novel organism associated with chronic diarrhoea in Aids. Lancet 335: 169–170

    Article  PubMed  CAS  Google Scholar 

  21. Havlik JA, Horsburgh CR, Metchok B, Williams PP, Fann SA, Thompson SE (1992) Disseminated Mycobacterium avium complex infection: clinical identification and epidemiologic trends. J Infect Dis 165: 577–580

    Article  PubMed  Google Scholar 

  22. Heise W, Mosterz P, Skörde J, L’age M (1988) Gastrointestinale Befunde bei der HIV-Infektion. Dtsch Med Wochenschr 113: 1588–1593

    Article  PubMed  CAS  Google Scholar 

  23. Hellyer TJ, Brown IN, Taylor MB, Allen BW, Easmon CSF (1993) Gastrointestinal involvement in Mycobacterium avium-intracellulare infection of patients with HIV. J Infect 26: 55–66

    Article  PubMed  CAS  Google Scholar 

  24. Herrmann JE, Taylor DN, Echeverria P, Blacklow NR (1991) Astrovirus as a cause of gastroenteritis in children. N Engl J Med 324: 1757–1760

    Article  PubMed  CAS  Google Scholar 

  25. Herndier BG, Friedman SL (1992) Neoplasms of the gastrointestinal tract and hepatobiliary system in acquired immunodeficiency syndrome. Sem Liver Dis 12: 128–141

    Article  CAS  Google Scholar 

  26. Lew JF, Moe CL, Monroe SS, Allen JR, Harrison BM, Forrester BD, Stine SE, Woods PA, Hierholzer JC, Herrmann JE, Blacklow NR, Bartlett AV, Glass RI (1991) Astrovirus and adenovirus associated with diarrhea in children in day care settings. J Infect Dis 164: 673–678

    Article  PubMed  CAS  Google Scholar 

  27. Long EG, White EH, Carmichael WW, Quinlisk PM, Raja R, Swisher BL, Daugharty H, Cohen MT (1991) Morphologic and staining characteristics of a cyanobacterium-like organism associated with diarrhea. J Infect Dis 164: 199–20

    Article  PubMed  CAS  Google Scholar 

  28. Malebranche R, Arnoux E, Guerin JM, Pierre GD, Laroche AC, Elie R, Morisset PH, Spira T, Mandeville R, Drotman P (1983) Acquired immunodeficiency syndrome with severe gastrointestinal manifestations in Haiti. Lancet II: 873–877

    Google Scholar 

  29. McGowan I, Hawkins AS, Weller IVD (1993) The natural history of aryptosporidial diarrhoea in HIV-infected patients. Aids 7: 349–354

    Article  PubMed  CAS  Google Scholar 

  30. Molina JM, Sarfati C, Beauvais B, Lémann M, Lesourd A, Ferchal F, Casin I, Lagrange P, Modigliani R, Derouin F, Modai J (1993) Intestinal microsporidiosis in human immunodeficiency virus-infected patients with chronic unexplained diarrhea: prevalence and clinical and biologic features. J Infect Dis 167: 217–221

    Article  PubMed  CAS  Google Scholar 

  31. Nime FA, Burek JD, Page DL, Holscher MA, Yardley JH (1976) Acute enterocolitis in a human being infected with the protozoan Cryptosporidium. Gastroenterology 70: 1156–1160

    Google Scholar 

  32. Orenstein JM, Tenner M, Cali A, Kotler DP (1992) A microsporidian previously undescribed in humans, infecting enterocytes and macrophages, and associated with diarrhea in an acquired immunodeficiency syndrome patient. Hum Pathol 23: 722–728

    Article  PubMed  CAS  Google Scholar 

  33. Ortega YR, Sterlin CR, Gilman RH, Cama VA, Diaz F (1993) Cyclospora species — a new protozoan pathogen of humans. N Engl J Med 328: 1308–1312

    Article  PubMed  CAS  Google Scholar 

  34. Quinn TC, Piot P, McCormick JB, Feinsod FM, Taelman H, Kapita B, Stevens W, Fauci AS (1987) Serologic and immunologic studies in patients with Aids in North America and Africa. JAMA 252: 2617–2621

    Article  Google Scholar 

  35. Rabeneck L, Gyorkey F, Genta RM, Gyorkey P, Foote LW, Risser MH (1993) The role of microsporidia in the pathogenesis of HIV-related chronic diarrhea. Ann Int Med 119: 895–899

    PubMed  CAS  Google Scholar 

  36. Ravn P, Lundgren JD, Kjaeldgaard P, Holten-Anderson W, Hojling N, Nielsen JO, Gaub J (1991) Nosocomial outbreak of cryptosporidiosis in Aids patients. Br Med J 302: 277–280

    Article  CAS  Google Scholar 

  37. René E, Marche C, Regnier B, Saimot AG, Vilde JL, Perrone C, Michon C, Wolf M, Chevalier T, Vallot T et al. (1989) Intestinal infections in patients with acquired immunodeficiency syndrome. Dig Dis Sci 34: 773–780

    Article  PubMed  Google Scholar 

  38. Riecken EO, Zeitz M, Ullrich R (1990) Non-opportunistic causes of diarrhoea in HIV infection. Baill Clin Gastroenterol 4: 385–403

    Article  CAS  Google Scholar 

  39. Schattenkerk JKME, van GoolT, van Ketel RJ, Barteisman JFWM, Kuiken CL, Terpstra WJ, Reis P (1991) Clinical significance of small-intestinal microsporidiosis in HIV-1-infected individuals. Lancet 337: 895–898

    Article  Google Scholar 

  40. Schneider T, Ullrich R, Zeitz M (1994) Gastrointestinale Manifestation bei der HIV-Infektion. Z Gastroenterol 32: 174–181

    PubMed  CAS  Google Scholar 

  41. Shlim DR, Cohen MT, Eaton M, Rajah R, Long EG, Ungar BLP (1991) An alga-like organism associated with an outbreak of prolonged diarrhea among foreigners in Nepal. Am J Trop Med Hyg 45: 383–389

    PubMed  CAS  Google Scholar 

  42. Smith PD (1991) Role of cytokines in infectious and noninfectious enteropathy in patients with Aids. Immunol Res 10: 447–451

    Article  PubMed  CAS  Google Scholar 

  43. Ullrich R, Heise W, Bergs C, L’age M, Riecken EO, Zeitz M (1992) Effects of zidovudine treatment on the small intestinal mucosa in patients infected with HIV. Gastroenterol 102: 1483–1492

    CAS  Google Scholar 

  44. Ullrich R, Heise W, Bergs C, L’age M, Riecken EO, Zeitz M (1992) Gastrointestinal symptoms in patients infected with human immunodeficiency virus: relevance of infective agents isolated from gastrointestinal tract. Gut 33: 1080–1084

    Article  PubMed  CAS  Google Scholar 

  45. Weber R, Bryan RT, Owen RL, Wilcox CM, Gorelkin L, Visvesvara GS (1992) Improved light-microscopical detection of microsporidia spores in stool and duodenal aspirates. N Engl J Med 326: 161–166

    Article  PubMed  CAS  Google Scholar 

  46. Zeitz M, Ullrich R (1992) Der Gastrointestinaltrakt bei der HIV-Infektion. Aids-Forsch 7: 227–240

    Google Scholar 

Download references

Authors
  1. T. Weinke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Ullrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. O. Riecken
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Medizinische Klinik II, Zentrum der Inneren Medizin, Klinikum der Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt a. M., Deutschland

    Wolfgang F. Caspary

  2. Institut für Medizinische Mikrobiologie und Hygiene, Universität Freiburg, Hermann-Herder-Str. 11, 79104, Freiburg, Deutschland

    Manfred Kist

  3. Medizinische Klinik und Poliklinik, Innere Medizin II, Universität des Saarlandes, 66421, Homburg/Saar, Deutschland

    Martin Zeitz

Rights and permissions

Reprints and permissions

Copyright information

© 1994 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Weinke, T., Ullrich, R., Riecken, E.O. (1994). Erregernegative Diarrhö vs. neue Erreger bei HIV-infizierten Patienten. In: Caspary, W.F., Kist, M., Zeitz, M. (eds) Ökosystem Darm VI. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-85187-2_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-85187-2_4

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-58548-0

  • Online ISBN: 978-3-642-85187-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation