Dysentery in patients infected with human immunodeficiency virus in Zimbabwe: an emerging role for Schistosoma mansoni and Escherichia coli O157?
Information on bloody diarrhoea in HIV-positives is scarce. A prospective study was therefore performed, in Zimbabwe, to determine and compare the pathogens associated with bloody diarrhoea in 25 antiretroviral-naïve HIV-infected patients and 15 non-HIV-infected patients. Stool cultures and colonic biopsies were performed. Shigella was isolated from 18 (45%) of the subjects, Schistosoma mansoni from eight (16%), Escherichia coli H7:O157 from three (8%) and Campylobacter jejunii from two (5%). There was no evidence of Salmonella, Entamoeba histolytica or cytomegalovirus infection. Shigella dysenteriae type-1 occurred more often in the HIV-negatives than the HIV-positives (P = 0.02). Although HIV-associated bloody diarrhoea in Zimbabwe appears to be most frequently caused by Shigella, it may also be commonly the result of infection with Sc. mansoni or shiga-toxin-producing E. coli. A larger study specifically to examine the role of Sc. mansoni and E. coli O157 is warranted.
Gwavava
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Department of Medicine, University of Zimbabwe Medical School, P.O. Box A178, Avondale, Harare, Zimbabwe.
Chihota
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Gangaidzo
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Gumbo
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D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology*; D000328:Adult; D000818:Animals; D002169:Campylobacter Infections / Q000382:microbiology; D016123:Campylobacter jejuni / Q000302:isolation & purification; D016022:Case-Control Studies; D004403:Dysentery / Q000382:microbiology*; D004405:Dysentery, Bacillary / Q000382:microbiology; D004927:Escherichia coli Infections / Q000382:microbiology*; D019453:Escherichia coli O157 / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012550:Schistosoma mansoni / Q000302:isolation & purification*; D012555:Schistosomiasis mansoni / Q000382:microbiology*; D012761:Shigella boydii / Q000302:isolation & purification; D012762:Shigella dysenteriae / Q000302:isolation & purification; D012763:Shigella flexneri / Q000302:isolation & purification