An important topic for us to cover would actually be GI manifestations.
That would be occurring during a patient who has AIDS.
Viral gastroenteritis is important.
Just like we have done earlier but the esophagus
when there is an immunocompromised patient, the CMV (Cytomegalovirus)
may either caused issues within the colon resulting in enteritis
or perhaps esophagitis. HSV, not only with HSV
and immunocompromised patient cause the esophagitis that I showed you picture of
with diffused inflammation of the esophagus with endoscopy
but there also be colitis in addition there´d be issues with the proctitis.
Adenovirus: non-bloody diarrhea also part of immunocompromised patient
with the viral type of enteritis. Bacterial manifestations of gastroenteritis in AIDS
include the following: If the CD4 count drops below 50,
you should be thinking about bacteria such as mycobacterium avium intracellulare,
diarrhea, weight loss, malabsorptions, small bowel biopsy
would be required for absolute diagnosis.
In addition, other bacteria that might be involved as well in an AIDS patient,
have your pick, really: Salmonella, shigella, and even if you didn´t have AIDS,
the most common cause of gastroenteritis would be campylobacter jejuni.
No surprise here. However, the most common cause of diarrhea in an AIDS patient is
cryptosporidium parvum, excuse me, and other bacteria that might be involved as well.
For example, you´ve heard of microspora and isospora
and interesting places where you might pick up these organisms
include raspberries and company.
Fungi. Candida, we´ve talked about with well, once again a couple of places.
In an immunocompromised patient you could have Candida infection within the mouth
welcome to oral thrush. You can have candidiasis of the esophagus
and you might have white, yellow-like plaque
such you might find on upper endoscopy.
Also, fungi Histoplasma: colitis.
Immunocompromised patient. Protozoa cryptosporidium parvum:
Make sure you know the treatment for this.
It is one of the most common causes of diarrhea in an AIDS patient with paromomycin.
Isospora: (I would know this as well) cotrimoxazole.
Microsporidia: really no effective treatment.
Others include Entamoeba histolytica in which not only would you have diarrhea
and colitis but then you might also have involvement of the liver.
Welcome to liver abscesses. Giardia lamblia could also be found.
Giardiasis and also what´s known as Blastocystitis hominis.