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Co-Occurring Conditions.

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Opportunistic Infections: TreatmentQuestion 19/20

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A 29-year-old cisgender woman with HIV presents for evaluation of diarrhea. She is from Haiti and arrived in the United States 2 weeks ago. She describes multiple daily episodes of watery, nonbloody diarrhea associated with low-grade fever, bloating, cramping abdominal pain, and anorexia. She says her last CD4 count was about 70 cells/mm3. She recently started bictegravir-tenofovir alafenamide-emtricitabine. A modified acid-fast stain of a stool sample demonstrates large (15 to 30 µm), red, elliptical-shaped oocysts (Figure 1).

In addition to continuing antiretroviral therapy, which one of the following antimicrobial regimens is recommended as appropriate acute therapy for this gastrointestinal infection?

This modified acid fast stain of a stool sample shows an <em>I. belli</em> sporoblast, which are typically 15 by 30 microns in size.
Figure 1. Modified Acid-Fast Stain of a Stool Sample.
This modified acid fast stain of a stool sample shows an I. belli sporoblast, which are typically 15 by 30 microns in size.
Image courtesy of Carolyn Wallis, Harborview Medical Center Microbiology Laboratory.
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Question Last Updated
September 29th, 2023

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