HIV diarrhea: Difference between revisions
| Line 4: | Line 4: | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
*Ascertain whether small bowel vs large bowel diarrhea | |||
**Small Bowel | |||
***Diarrhea watery and copius | |||
***Weight loss | |||
***Bloating, gas, cramping | |||
***Vit B12 deficient if terminal illeum involved | |||
**Large Bowel | |||
***Frequent small volume, possibly painful stools | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 20:08, 18 March 2015
Background
- Chronic diarrhea (over 28 days), can be presenting symptom of AIDS, or in countries without HAART
- Less common after introduction of HAART
Clinical Presentation
- Ascertain whether small bowel vs large bowel diarrhea
- Small Bowel
- Diarrhea watery and copius
- Weight loss
- Bloating, gas, cramping
- Vit B12 deficient if terminal illeum involved
- Large Bowel
- Frequent small volume, possibly painful stools
- Small Bowel
Differential Diagnosis
CD4>400
- Consider routine pathogens causing Diarrhea
- Side effect of nelfinavir and ritonavir
- Cryptosporidium parvum (brief course of illness)
CD4<200
- Cryptosporidium parvum (chronic course of illness)
- Mycobacterium avium complex (MAC) - infiltration of bowel assoc with malabsorption
- Lymphoma
- Kaposi
- Enteroaggregative Escherichia coli (EAEC) (can also affect immunocompetent children)
- HIV can directly infiltrate bowel wall leading to diarrhea
Diagnosis
Management
Disposition
See Also
References
UpToDate: "Evaluation of the HIV-infected patient with diarrhea"