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Chronic Diarrhea and Malabsorption Associated with Enteropathogenic Bacterial Infection in a Patient with AIDS

Donald P. Kotler, MD; and Jan M. Orenstein, MD, PhD
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From St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, New York, and George Washington University School of Medicine, Washington, DC. Requests for Reprints: Donald P. Kotler, MD, Section of Gastrointestinal Immunology, S&R 1301, St. Luke's-Roosevelt Hospital Center, 421 West 113th Street, New York, NY 10025. Grant Support: In part by grant AI21414 from the National Institutes of Health.

Copyright 2004 by the American College of Physicians

Ann Intern Med. 1993;119(2):127-128. doi:10.7326/0003-4819-119-2-199307150-00006
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Chronic diarrhea and weight loss are common in patients with the acquired immunodeficiency syndrome (AIDS) [1]. Although several infectious causes may be found, no cause is identified in as many as 50% of cases [14]. Other possible causes include as yet unidentified pathogens, the human immunodeficiency virus (HIV) itself [5], and noninfectious processes. We describe a patient who had evidence of chronic intestinal injury associated with enteropathogenic bacterial infection.

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Figure 1.
Attaching and effacing lesion. Top.Bottom.

Light microscopic view of bacteria adherent to the superficial epithelium in the cecum (hematoxylin and eosin; original magnification, 160). Three bacteria are intimately associated with the luminal plasma membrane of an ileal epithelial cell. Note the absence of microvilli, the plaque-like attachments, and the concentration of cytoplasmic filaments (original magnification, 17 000).

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