Pancreatitis caused by Cryptosporidium parvum in patients with severe immunodeficiency related to HIV infection
Calzetti, C.; Magnani, G.; Confalonieri, D.; Capelli, A.; Moneta, S.; Scognamiglio, P.; Fiaccadori, F.
Annali italiani di medicina interna organo ufficiale della Societa italiana di medicina interna 12(2): 63-66
1997
ISSN/ISBN: 0393-9340 PMID: 9333315 Document Number: 473825
Up to the present, pancreatic complications due to cryptosporidium parvum infection have been described only in a few patients with acquired immunodeficiency syndrome (AIDS). We report our experience with 3 subjects with AIDS who presented with acute or chronic pancreatitis related to cryptosporidiosis. All 3 patients had abdominal pain resistant to analgesics, increased serum amylase and abnormalities at both sonography and computed tomography. Endoscopic retrograde cholangiopancreotography revealed papillary stenosis in all patients; one patient also had stenosis of the Wirsung duct. Cryptosporidium was found in both bile and stool samples in all patients, while viral cultures were negative, even in the 2 patients who had cytomegalovirus retinitis. Endoscopic sphincterotomy temporally relieved abdominal pain in all patients, but did not prevent either acute or recurrent pancreatic inflammation. Several antibiotic therapeutic protocols were ineffective against the parasite.