Cryptosporidiosis in Houston, Texas. A report of 95 cases.
Cryptosporidiosis is an important cause of diarrhea. We identified 95 patients with cryptosporidiosis over a 6-year period in our county hospital system, including 9 children and 86 adults infected with the human immunodeficiency virus (HIV). Risk factors included male-to-male sexual practices and Hispanic race. Diarrhea, weight loss, and gastrointestinal complaints were the most common symptoms at presentation. Among the HIV-infected adults, 20 (23%) developed biliary tract disease. Biliary involvement was associated with low CD4 counts. Treatment with paromomycin and antimotility agents was effective in reducing diarrheal symptoms in 54 of 70 (77%) patients with the acquired immunodeficiency syndrome (AIDS), although there was a high rate of relapse. Paromomycin did not prevent the development of biliary disease. Biliary disease responded to cholecystectomy or sphincterotomy with stent placement. Though often a cause of morbidity, cryptosporidiosis was only rarely the cause of death, even among patients with HIV. Cryptosporidiosis continues to be an important medical problem even in developed-countries. Current methods of prevention and treatment are suboptimal.
Hashmey
R
R
Department of Medicine, Baylor College of Medicine, Ben Taub General Hospital, Houston, TX 77030, USA.
Smith
N H
NH
Cron
S
S
Graviss
E A
EA
Chappell
C L
CL
White
A C
AC
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000175:diagnosis; D000328:Adult; D002648:Child; D015209:Cholangitis, Sclerosing / Q000209:etiology; D002764:Cholecystitis / Q000209:etiology; D003457:Cryptosporidiosis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009894:Opportunistic Infections / Q000150:complications / Q000175:diagnosis; D012008:Recurrence; D012307:Risk Factors; D012621:Seasons; D013781:Texas / Q000453:epidemiology