Pulmonary cryptosporidiosis in an AIDS patient: successful treatment with paromomycin plus azithromycin.
Extra-intestinal cryptosporidiosis, especially of the biliary and respiratory tract, is likely in the course of an intestinal involvement, whereas it is rare without such a localization. We report a case of pulmonary cryptosporidiosis without apparent intestinal involvement in an AIDS patient, with favourable outcome after antimicrobial combination therapy with paromomycin plus azithromycin. The successful response to antimicrobial treatment was subsequently maintained by effective highly active antiretroviral therapy (HAART). We suggest that respiratory cryptosporidiosis should be investigated in HIV-infected patients with pulmonary symptoms and low CD4 cell count, and, if detected, treatment should include HAART plus the combination of paromomycin and azithromycin.
Palmieri
F
F
Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, IRCCS, Via Portuense 292, 00149 Rome, Italy. f.palmieri@flash.net
Cicalini
S
S
Froio
N
N
Rizzi
E B
EB
Goletti
D
D
Festa
A
A
Macrí
G
G
Petrosillo
N
N
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000469:parasitology; D000818:Animals; D023241:Antiretroviral Therapy, Highly Active; D017963:Azithromycin / Q000627:therapeutic use*; D003457:Cryptosporidiosis / Q000188:drug therapy* / Q000469:parasitology; D016785:Cryptosporidium parvum / Q000187:drug effects*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008174:Lung Diseases, Parasitic / Q000188:drug therapy* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D010303:Paromomycin / Q000627:therapeutic use*; D016896:Treatment Outcome
D010303:Paromomycin; D017963:Azithromycin