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Isospora belli Infection: Treatment with Pyrimethamine

Louis M. Weiss, MD, MPH; David C. Perlman, MD; Jeffrey Sherman, MD; Herbert Tanowitz, MD; and Murray Wittner, MD, PhD
[+] Article, Author, and Disclosure Information

Grant Support: Partial support by Training Grant AI-17183 from the National Institutes of Health.

Requests for Reprints: Murray Wittner, MD, PhD, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Room 504F, Bronx, NY 10461.

Current Author Addresses: Drs. Weiss, Tanowitz, and Wittner: Albert Einstein College of Medicine, 1300 Morris Park Avenue, Room 504F, Bronx, NY 10461.

Dr. Perlman: 435 East 70th Street, 23A, New York, NY 10021.

Dr. Sherman: 806 Dale Drive, Silver Spring, MD 20910.

© 1988 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1988;109(6):474-475. doi:10.7326/0003-4819-109-6-474
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Isosporiasis is an uncommon but important diarrheal disease of humans that, like cryptosporidiosis, is life-threatening in patients with the acquired immunodeficiency syndrome (AIDS). Isospora belli infection responds rapidly to therapy with trimethoprim-sulfamethoxazole, but patients with AIDS have a high rate of adverse reactions to this therapy. The cases of two patients with AIDS, sulfonamide allergy, and I. belli infection are reported. They were treated successfully with pyrimethamine alone, 75 mg/d, and recurrence was prevented with daily pyrimethamine therapy, 25 mg/d. In patients with AIDS with sulfonamide allergy or intolerance, pyrimethamine alone seems to be a reasonable alternative therapy for I. belli infection.





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