September 04, 2012

An immunocompetent patient with diarrhea

An immuno-competent patient develops diarrhea. Image shows acid-fast on stool.

Click on image to enlarge
The treatment of choice would be:

a) Antiretroviral therapy
b) Metronidazole
c) Vancomycin
d) Albendazole
e) No antibiotics are necessary






ANSWER
The correct answer is E


Explanation
The most widely used diagnostic test is the modified acid-fast or Kinyoun stain. It is used to detect Cryptosporidium in stool samples. Several immunofluorescent assays are also available, which test for antibodies to the parasite in the blood. Some pharmaceutical companies have produced rapid-result commercial assays, which are moderately successful (~75% detection rate). Polymerase chain reaction (PCR) techniques might also prove to be effective in diagnosing infection.

Treatment usually is not required for cryptosporidiosis in patients who are immunocompetent, and no clinical trials have convincingly demonstrated the efficacy of antimicrobics.

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