TABLE 413-2 -ESOPHAGEAL COMPLICATIONS OF HIV INFECTION

AGENT	FREQUENCY*(% )	CD4 COUNT	CLINICAL FEATURES	DIAGNOSIS	TREATMENT
Acute Diarrhea
Salmonella	5-15	Any	Watery diarrhea, fever	Stool and blood culture	Fluoroquinolone
Clostridium difficile	10-15	Any	Cramps, watery diarrhea, fever	Stool toxin assay	Metronidazole
Enteric viruses	15-30	Any	Watery diarrhea, usually afebrile	None	Symptomatic
Idiopathic	25-40	Any	Variable	Negative culture, O&P exam, and C. difficile toxin	Symptomatic
Chronic Diarrhea
Cryptosporidium	10-30	<100	Watery diarrhea, fever variable, may be devastating fluid losses	Stool O&P with AFB	Paromomycin ± azithromycin
Microsporida	15-30	<100	Watery diarrhea, afebrile	Stool trichrome stain	Albendazole ( Enterocytozoon intestinalis)
Isospora	1-3	<100	Watery diarrhea	Stool O&P	TMP-SMX
Mycobacterium avium	10-20	<50	Watery diarrhea, fever, wasting	Blood culture	Clarithromycin + ethambutol
Cytomegalovirus	15-40	<50	Watery or bloody diarrhea; fever, fecal WBCs	Colon biopsy	Ganciclovir
Idiopathic	20-30	Any	Watery diarrhea	Negative culture, O&P, C. difficile toxin, endoscopy	Symptomatic

O&P = ova and parasites; AFB = acid-fast bacillus; TMP-SMX = trimethoprim-sulfamethoxazole; WBCs = white blood cells.

^* Frequency among HIV-infected patients with acute or chronic diarrhea