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Isospora belli

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Isospora belli, Cystoisospora belli, Isosporiasis

  • Epidemiology
  1. Seen primarily in advanced HIV in Caribbean, SW USA
  • Pathophysiology
  1. Gastrointestinal infection
  • Differential Diagnosis
  1. See Diarrhea in HIV
  2. Cryptosporidium parvum
  • Diagnosis
  1. Stool acid fast stain
  • Management
  1. Trimethoprim-sulfamethoxazole (Bactrim, Septra, TMP-SMZ) DS
    1. Dose: Septra DS one tab twice daily for 7-10 days
    2. Longer course (for 3-4 weeks) or increased frequency (four times daily) may be required in HIV or AIDS
  2. Alternative agents
    1. Pyrimethamine 50 to 75 mg orally daily and folinic acid 10-25 mg orally daily
    2. Ciprofloxacin 500 mg twice daily for 7 days (limited evidence)
  • Course
  1. Relapse in 50% of patients
  2. Chronic suppressive therapy may be necessary
    1. Example: Septra DS 1 tab orally three times weekly or once orally daily
  • References
  1. Gilbert (2016) Sanford Guide, on IOS, accessed 9/12/2016