インド渡航後にサイクロスポーラによる腸炎， 胆管症を認めたHIV 感染者の1 例

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  • A Case of HIV Infection Who Had Enterocolitis and Biliary Disease Due to Cyclospora after Traveling to India
  • 症例 インド渡航後にサイクロスポーラによる腸炎,胆管症を認めたHIV感染者の1例
  • ショウレイ インド トコウ ゴ ニ サイクロスポーラ ニ ヨル チョウエン,タンカンショウ オ ミトメタ HIV カンセンシャ ノ 1レイ

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<p>A 48-year-old HIV-positive female had discontinued her hospital visits for about 1.5 years. Immediately after returning from a 1.5-month stay in India, she suffered from diarrhea about four times a day and, therefore, visited our outpatient department. Liver dysfunction was noted on blood sampling, and bileduct dilatation was detected by magnetic resonance imaging (MRI)．Using feces, duodenum, and large intestine specimens, neon blue autofluorescence of the oocyst wall was detected under UV excitation with a fluorescence microscope. These specimens were molecularly biologically identified as Cyclospora cayetanensis using PCR sequencing. Since approval could not be obtained for the treatment of Cyclospora, only antiretroviral therapy (ART) was resumed. The CD4-positivity was above 180/μL for about 4 months, but alkaline phosphatase became exacerbated. Subsequently, the treatment of Cyclospora was started by prescribing trimethoprim/sulfamethoxazole (ST) (80/160mg, 4 tablets) for 10 days. The liver dysfunction and diarrhea were promptly alleviated, and the bileduct dilatation was improved on MRI. </p><p>In the present study, biliary disease and enteritis due to Cyclospora could be effectively treated with an ST formulation. Although it is well-known that C. cayetanensis causes not only enteritis, but also bile duct/biliary tract lesions in immunocompromised HIV-infected patients, such cases have rarely been reported in recent years.</p>

収録刊行物

  • 感染症学雑誌

    感染症学雑誌 92 (3), 371-375, 2018-05-20

    一般社団法人 日本感染症学会

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