French AL, Benator DA, Beaudet LM, Levy CS, Orenstein JM; National Conference on Human Retroviruses and Related Infections.
Program Abstr First Natl Conf Hum Retrovir Relat Infect Natl Conf Hum Retrovir Relat Infect 1st 1993 Wash DC. 1993 Dec 12-16; 99.
Washington Hospital Center, Washington, DC.
Isospora belli is an uncommon cause of disease in AIDS patients in the United States. We present a case of acalculous cholecystitis caused by Isospora belli in a patients with AIDS. The patient was a homosexual white male with a diagnosis of Kaposi's sarcoma. From 1987-1991 he had intermittent episodes of diarrhea associated with abdominal pain. Stool exam in 1987 revealed Endolimix nana, Entamoeba coli and Blastocystis hominis which cleared. All subsequent stool samples had no ova or parasites. A small bowel biopsy in January of 1991 was within normal limits. He was admitted in April of 1991 for RUQ pain, nausea, continued diarrhea and weight loss. Physical exam revealed low grade fever and RUQ tenderness. Laboratory exam was notable for WBC count 2,400/mm3 with 6% eosinophils. CD4 count was 72/mm3. Alkaline phosphatase, bilirubin and transaminase were normal. Abdominal US reveal a thick-walled gallbladder and on HIDA scan, the gallbladder did not visualize. He underwent laparoscopic cholecystectomy. The gallbladder was grossly inflamed. Histopathologic exam at the time revealed marked chronic cholecystitis of uncertain etiology. However, a review following the patients death revealed a moderately severe infection with Isospora belli. The patients course was characterized by continued nausea and abdominal pain. He underwent a second normal small bowel biopsy one month post- operatively. He died three months later following intussusception of the mid-transverse colon. No evidence of Isospora was found in the removed colon. This is the first case to our knowledge of this potentially treatable parasite causing acalculous cholecystitis in AIDS.
Publication Types:
Keywords:
- Abdominal Pain
- Acalculous Cholecystitis
- Acquired Immunodeficiency Syndrome
- Animals
- Blastocystis hominis
- CD4 Lymphocyte Count
- Cholecystectomy, Laparoscopic
- Cholecystitis
- Diarrhea
- Gallbladder
- Humans
- Isospora
- Male
- Sarcoma, Kaposi
- United States
- Weight Loss
- etiology
- surgery
Other ID:
UI: 102214213
From Meeting Abstracts