AIDS-ASSOCIATED CRYPTOSPORIDIOSIS WITH GASTRIC STRICTURE AND A THERAPEUTIC RESPONSE TO PAROMOMYCIN

AIDS-associated cryptosporidiosis has been associated with severe, wat ery diarrhea and with multifocal biliary stricture. Gastric involvemen t has not been reported prominently. We report here the case of a 28-y r-old AIDS patient who developed typical watery diarrhea, followed by subtotal gastric obstruction secondary to antral stricturing. Biopsy o f the stricture revealed severe inflammation and marked cryptosporidia l infestation. Extensive workup excluded causes of stricture. He was e mpirically treated with paromomycin, with a surprisingly positive ther apeutic response and clinical resolution of obstruction. Antral strict ure may be another manifestation of cryptosporidial infection in AIDS. Paromomycin deserves further evaluation as an agent for treatment of this infection.