Endoscopic evaluation of chronic human immunodeficiency virus-related diarrhea
Boujaoude, J.; Assaf, E.; Nasnas, R.; Abadjian, G.; Khouri, K.
Le Journal Medical Libanais. Lebanese Medical Journal 48(5): 298-301
2000
ISSN/ISBN: 0023-9852 PMID: 12494911 Document Number: 522276
Chronic diarrhea is an important clinical problem in patients infected with HIV. Data assessing the diagnostic yield of upper and lower endoscopy are limited. We reported 10 cases of HIV-infected patient referred to our hospital for chronic diarrhea from March 1995 to June 1999. 60% of the pathogens were identified obviously by stool studies. Cryptosporidium and Mycobacterium avium intracellulare (MAI) were the most common organisms. In this study, endoscopy identified 2 additional cases of MAI and one of 5 cryptosporidia detected in stool. Immunologic test identified a CMV infection in one case. Stool tests and endoscopy identified obviously 80% of the pathogens. Most investigators and us agree that stool studies should be the first diagnostic test. In patients with negative stool studies, lower endoscopy is more cost-effective than upper endoscopy and indicated as an initial exam.