TREATMENT OF CRYPTOSPORIDIAL DIARRHEA IN AN AIDS PATIENT WITH PAROMOMYCIN

OBJECTIVE: To report a case of diarrhea caused by Cryptosporidium in a n AIDS patient which was successfully treated with paromomycin. CASE S UMMARY: An AIDS patient with a 12-month history of cryptosporidial dia rrhea unresponsive to other treatment measures was treated with paromo mycin 500 mg q6h for 14 days. Before initiating therapy, the patient w as experiencing, on average, 20 bowel movements per day and had lost m ore than 25 kg. after therapy was initiated, the number of bowel movem ents dropped to 1-2 per day and the patient began to gain weight. The diarrhea recurred when therapy was discontinued. After retreatment far 14 days with paromomycin 500 mg q6h, the diarrhea stopped. The patien t has not had a recurrence of Cryptosporidium diarrhea, stool cultures remain negative for Cryptosporidium occysts, and the patient has rega ined most of the weight. DISCUSSION: Literature concerning the use of paromomycin for the treatment of cryptosporidiosis is discussed. A tre atment algorithm for the management of cryptosporidiosis in AIDS patie nts is presented. CONCLUSIONS: We believe that we have presented a cle ar example of a case in which paromomycin was effective in treating an d eradicating intestinal cryptosporidiosis in an AIDS patient Paromomy cin is the most effective agent available to date for the treatment of this devastating complication of AIDS.