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Cytomegalovirus and Cryptosporidium infections in AIDS: a necropsy study

P Viriyavejakul1, P Rojanasunan, A Viriyavejakul

  • 1Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. tmpvr@mahidol.ac.th

Insights

This case report details a fatal coinfection of cytomegalovirus (CMV) and Cryptosporidium in an AIDS patient presenting with chronic diarrhea. Diagnosis was only confirmed postmortem, highlighting the need for improved diagnostic methods.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Acquired Immunodeficiency Syndrome (AIDS) patients are susceptible to opportunistic infections.
  • Chronic diarrhea is a common and debilitating symptom in advanced HIV/AIDS.
  • Coinfections can complicate diagnosis and treatment in immunocompromised individuals.

Observation:

  • A single AIDS patient presented with persistent chronic diarrhea.
  • The patient's condition was fatal, with diagnosis only achieved postmortem.
  • Autopsy revealed cytomegalovirus (CMV) intranuclear inclusions in the ileum, colon, and appendix.

Findings:

  • Postmortem examination confirmed coinfection with cytomegalovirus (CMV) and Cryptosporidium.
  • CMV inclusions were identified in multiple sections of the gastrointestinal tract.
  • Cryptosporidium oocysts were observed on the colonic brush border.

Implications:

  • This case underscores the diagnostic challenges in identifying opportunistic gastrointestinal pathogens in AIDS patients.
  • Enhanced diagnostic procedures, including colonic biopsy and specialized staining, are crucial for early etiological diagnosis.
  • Timely diagnosis of CMV and Cryptosporidium coinfections can potentially guide earlier therapeutic interventions in similar cases.

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