Gastrointestinal Manifestations of AIDS

by Carlo Raj, MD

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    00:01 An important topic for us to cover would actually be GI manifestations.

    00:05 That would be occurring during a patient who has AIDS.

    00:09 Viral gastroenteritis is important.

    00:13 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.

    00:50 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.

    01:17 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.

    01:34 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.

    01:46 For example, you´ve heard of microspora and isospora and interesting places where you might pick up these organisms include raspberries and company.

    01:56 Fungi. Candida, we´ve talked about with well, once again a couple of places.

    02:02 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.

    02:18 Also, fungi Histoplasma: colitis.

    02:23 Immunocompromised patient. Protozoa cryptosporidium parvum: Make sure you know the treatment for this.

    02:32 It is one of the most common causes of diarrhea in an AIDS patient with paromomycin.

    02:37 Isospora: (I would know this as well) cotrimoxazole.

    02:42 Microsporidia: really no effective treatment.

    02:47 Others include Entamoeba histolytica in which not only would you have diarrhea and colitis but then you might also have involvement of the liver.

    02:55 Welcome to liver abscesses. Giardia lamblia could also be found.

    03:00 Giardiasis and also what´s known as Blastocystitis hominis.

    About the Lecture

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

    Author of lecture Gastrointestinal Manifestations of AIDS

     Carlo Raj, MD

    Carlo Raj, MD

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