AIDS-related cholangitis in children: sonographic findings.

Rusin, Jerome; Sivit, Carlos J.; Rakusan, Tamara A.; Chandra, Rudi

doi:10.2214/ajr.159.3.1503039

Cited by 14 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is not known whether abdominal pain in the boy was related to intestinal microsporidiosis. Intermittent abdominal pain may also be a manifestation of AIDS cholangiopathy, a condition that has been described in adults and in two children [24,25]. In some patients, AIDS cholangiopathy and AIDS-related sclerosing cholangitis have been related to opportunistic pathogens such as Cryptosporidium species, cytomegalovirus, and-most recently-E. bieneusi [22,24,25].…”

Section: Discussionmentioning

confidence: 99%

Intestinal Coinfection with Enterocytozoon bieneusi and Cryptosporidium in a Human Immunodeficiency Virus-Infected Child with Chronic Diarrhea

Weber

Sauer²,

Lüthy³

et al. 1993

Clinical Infectious Diseases

View full text Add to dashboard Cite

The microsporidian Enterocytozoon bieneusi has been recognized as an important cause of chronic diarrhea in severely immunodeficient adults infected with human immunodeficiency virus (HIV). We report the first case of intestinal E. bieneusi infection in a child. The 9-year-old boy with connatal HIV infection presented with failure to thrive, chronic diarrhea, and intermittent abdominal pain. His CD4 lymphocyte count was 0.05 X 109/L and dropped to 0.01 X 109/L. No HIV-associated opportunistic infection other than oral hairy leukoplakia and oral candidiasis had been found before microsporidia were detected. Treatment of microsporidiosis with albendazole was of no benefit. During follow-up, the boy also developed intestinal cryptosporidiosis. Evaluation of chronic diarrhea in severely immunodeficient HIV-infected children should include examination for intestinal microsporidia. We recommend the use of a new coprodiagnostic technique that allows detection of microsporidial spores in stool specimens. Furthermore, consideration of dual or even multiple parasitic infections in the differential diagnosis of chronic diarrhea may have both important clinical and epidemiological implications.The microsporidian protozoan organism Enterocytozoon bieneusi, first reported in 1985 [1, 2], has been recognized as a human immunodeficiency virus (HIV)-associated intestinal opportunistic pathogen [1][2][3][4][5][6][7][8][9]. Preliminary epidemiological studies have indicated that it may be present in 10%-30% of severely immunodeficient HIV-infected adults with chronic diarrhea [3][4][5][6]9].We report the first case in which an HIV-infected pediatric patient with chronic diarrhea was found to have E. bieneusi spores in stool specimens by light-microscopic and electronmicroscopic examination. During follow-up, the child also developed intestinal cryptosporidiosis. Case ReportThe patient, a 9-year-old boy, was born in Switzerland to an HIV-seropositive Swiss mother with a history of intravenous drug use. Between the ages of 3 and 8 years, the boy lived with his mother in Ecuador before his return to Switzerland. His mother died of AIDS-related complications in February 1992. She did not have diarrhea. The boy developed normally and was healthy until summer 1991, when he expe- rienced intermittent diarrhea, abdominal pain, and mild dry cough without fever.In September 1991, he was referred to the University Children's Hospital in Zurich because of persistent gastrointestinal symptoms. He had three to six watery stools per day and intermittent nonspecific diffuse abdominal pain. His weight (19.3 kg) and height (118 cm) were below the third percentile. Physical examination was normal apart from oral hairy leukoplakia and oral candidiasis. He was found to be positive for antibody to HIV-1, and the results of HIV-1 culture also were positive. The hematocrit was 0.31, the leukocyte count was 4.6 X 109/L with a CD4 + count of 0.05 X 109/L and a CD8 + lymphocyte count of 2.03 X 10 9/L. Tests of functional immune status disclosed antibody def...

show abstract