DUODENAL MUCOSA CYTOLOGY IN HIV-POSITIVE PATIENTS WITH CHRONIC DIARRHEA

The cytologic findings of duodenal smears in diarrheic HIV-positive pa tients were compared with results of histologic and ultrastructural st udies. This study included 50 diarrheic patients undergoing upper gast rointestinal endoscopy. Duodenal biopsies were taken with touch prepar ations. Smears were stained with Giemsa and then with Ziehl-Neelsen or the PAS method. The biopsy specimens were then processed in a standar d fashion for histologic and electron microscopy examination. Cytologi c findings included 8 cases of intestinal microsporidiosis, 4 cases of cryptosporidiosis, and 3 cases of atypical mycobacteriosis. Histologi c and ultrastructural studies confirmed these diagnoses and showed 8 c ases of CMV enteritis, of which 4 were associated with other enteric p athogens. Duodenal cytology complements endoscopic biopsy in the work- up of diarrhea in AIDS patients and may provide a rapid diagnosis espe cially in the case of intestinal protozoonosis or atypical intestinal mycobacteriosis.