Gastrointestinal Manifestations of AIDS

by Carlo Raj, MD

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    An important topic for us to cover would actually be GI manifestations that would be occuring during a patient who has AIDs. Viral gastroenteritis is important. Just like we had then earlier with the esophagus when there is an immunocompromised patient, the CMV, Cytomegalovirus, may either cause issues within the colon resulting in enteritis or perhaps esophagitis. HSV Not only with HSV in immunocompromised patient cause the esophagitis that I showed you a picture of with diffuse inflammation of the esophagus with endoscopy. But there will also be colitis. In addition, there would 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 <i>Mycobacterium avium intracellulare</i>. Diarrhea, weight loss, malabsorption, small bowel biopsy would be required for absolute diagnosis. In addition, other bacteria that might be involved as well in an AIDS patient, well, have your pick really, <i>Salmonella, Shigella.</i> And even if you didn't have AIDS, the most common cause of gastroenteritis will be <i>Campylobacter jejuni</i>, no surprise here. However, the most common cause of diarrhea in an AIDS patient is <i>Cryptosporidium parvum</i>, 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 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 could have candidiasis of the esophagus and you might have white, yellow–like plaques that you might find on upper endoscopy. Also, fungi Histoplasma: Colitis Immunocompromised patient Protozoa <i>Crytosporidium parvum</i> Make...

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    The lecture Gastrointestinal Manifestations of AIDS by Carlo Raj, MD is from the course Small and Large Intestine Diseases.

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     Carlo Raj, MD

    Carlo Raj, MD

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