RESUMO
Extra-intestinal cryptosporidiosis, especially of the biliary and respiratory tract, is likely in the course of an intestinal involvement, whereas it is rare without such a localization. We report a case of pulmonary cryptosporidiosis without apparent intestinal involvement in an AIDS patient, with favourable outcome after antimicrobial combination therapy with paromomycin plus azithromycin. The successful response to antimicrobial treatment was subsequently maintained by effective highly active antiretroviral therapy (HAART). We suggest that respiratory cryptosporidiosis should be investigated in HIV-infected patients with pulmonary symptoms and low CD4 cell count, and, if detected, treatment should include HAART plus the combination of paromomycin and azithromycin.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Azitromicina/uso terapêutico , Criptosporidiose/tratamento farmacológico , Cryptosporidium parvum/efeitos dos fármacos , Pneumopatias Parasitárias/tratamento farmacológico , Paromomicina/uso terapêutico , Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Animais , Terapia Antirretroviral de Alta Atividade , Criptosporidiose/parasitologia , Quimioterapia Combinada , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Pneumopatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
A 34-year-old woman presented with a 10-year history of recurrent oral and genital ulcerations and recurrent episodes of bilateral conjunctivitis associated with HIV infection. A diagnosis of Behçet's disease (BD) in association with keratoconjunctivitis sicca (KCS) was made after exclusion of other viral and autoimmune diseases according to the international criteria for BD. This is the first reported case of a combination of BD and KCS in a patient with HIV infection in which a complete resolution was observed as a result of successful highly active antiretroviral therapy. The likelihood that a direct viral effect or HIV-induced autoimmune mechanisms act in the pathogenesis of both BD and KCS in HIV-infected patients is discussed.