Edson Duarte Moreira Junior

Identificação de isosporíase em pacientes com síndrome de imunodeficiência adquirida em Salvador, Bahia

In the US only .2% of AIDS patients are afflicted with Isospora belli infection in Brazil less than 1% of patients were diagnosed with isosporosis while in Haiti 15% present with this infection. 7 cases of AIDS with chronic diarrhea caused by this infection are presented. The diagnosis of isosporosis was established by the direct stool examination using the modified Ziehl-Neelsen coloration test. All patients were treated with 800 mg of sulfamethoxazole and 160 mg of trimetoprim orally 4 times/day for 10 days subsequently 2 times/day for 2 weeks and maintaining a daily dose 3 times/week for prophylaxis of recurrence. The patients had watery diarrhea without mucus or blood with 11 +or- 3 evacuations/day accompanied by diffuse abdominal pain. Treatment resolved the diarrhea within 3.5 +or- 1.7 days. Diarrhea is a common symptom in AIDS patients. 76 (69%) of 110 AIDS patients in Bahia had diarrhea and the identification of the etiologic agent occurred in only 28 (37%) of these. The above coloration method for the detection of the coccidia Isospora belli and Cryptosporidium sp. should be included in routine diagnostic investigation of patients with diarrhea and AIDS since this would facilitate the detection of a treatable infection whose incidence is probably underestimated by means of a simple and noninvasive method.