July 14, 2010

MRCP 2 Question 13

An immuno-competent patient develops diarrhea.

Study the slide above carefully.

From this slide, the treatment of choice would be:

a) antiretroviral therapy
b) metronidazole
c) vancomycin
d) albendazole
e) no antibiotics are necessary

The correct answer is E


Look at the brush border, there are several small spores.

Once believed not to be a pathogen in humans, these little creatures live in the brush border of the gut and are an important cause of diarrhea worldwide. In people who are immunocompromised, it can be hard to shake off the infection.

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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