Gabor P. Kandel, MD
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To the Editors: As a practicing gastroenterologist in an urban center, I am grateful for the authoritative review by Smith and colleagues (1) on gastrointestinal infections in the acquired immunodeficiency syndrome (AIDS). I am puzzled, however, by their unqualified enthusiasm for endoscopy in the workup of diarrhea in these patients. The authors mention that in the National Institutes of Health (NIH) series, 45% of these patients had cytomegalovirus (2), the most frequent pathogen found by colonoscopy but not detectable by stool analysis or sigmoidoscopy. My experience is closer to that reported by Connolly and colleagues (3, 4), where cytomegalovirus colitis
Kandel GP. Diagnostic Workup of AIDS-associated Diarrhea. Ann Intern Med. 1992;117:346–347. doi: 10.7326/0003-4819-117-4-346
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Published: Ann Intern Med. 1992;117(4):346-347.
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