A Case of HIV Infection Who Had Enterocolitis and Biliary Disease Due to Cyclospora after Traveling to India

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  • SEKIYA Ryoko
    Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital
  • FUKUSHIMA Kazuaki
    Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital
  • TANAKA Masaru
    Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital
  • YAJIMA Keishiro
    Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital
  • YAGITA Kenji
    Department of Parasitology, The National Institute of Infectious Diseases
  • AJISAWA Atsushi
    Toshima Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation
  • IMAMURA Akifumi
    Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital

Bibliographic Information

Other Title
  • 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
  • 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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Description

<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>

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 92 (3), 371-375, 2018-05-20

    The Japanese Association for Infectious Diseases

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