CAUSES OF CHRONIC DIARRHEA IN PATIENTS WITH AIDS IN THAILAND - A PROSPECTIVE CLINICAL AND MICROBIOLOGICAL STUDY

A prospective study was designed to investigate the causes of chronic diarrhea in AIDS patients in Thailand. Forty-five patients from Bamras naradura Infectious Diseases Hospital were enrolled. Extensive investi gations included multiple stool examinations for ova and parasites, us ing the stool formalin-ether concentration method, stool culture, stoo l acid-fast bacilli (AFB) stain, stool modified AFB stain, esophago-ga stroduoscopy with duodenal aspirate and biopsy, and colonoscopy with b iopsy. Biopsied specimens were examined with H&E, Giemsa, Gram, Period ic acid Schiff, and AFB stains. Definitive causes were found in 29 pat ients (64.4%). Of these 29, 7 patients were found to habor more than 1 pathogen (15.5%). The most commonly found enteric pathogen was Crypto sporidium parvum (20.0%). Less frequently found pathogens were Mycobac terium tuberculosis (17.8%), Salmonella spp. (15.5%), Cytomegalovirus (11.1%), Mycobacterium avium intracellulare (6.6%), Strongyloides ster coralis (4.4%), Giardia lamblia (4.4%), Cryptococcus neoformans (2.2%) , Histoplasma capsulatum (2.2%), Campylobacter jejun (2.2%), and Cyclo spora cayetanensis (2.2%). Salmonella spp., Mycobacterium tuberculosis , and Mycobacterium avium intracellulare infections were shown to be m ore common in Thailand than in African countries.