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Gastrointestinal
Diagnosis
Small Intestine
Infection
Opportunistic Intestinal Infections
Opportunistic Intestinal Infections
Atif Zaheer, MD, FSAR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Symptomatic gastrointestinal (GI) infection of immunocompromised host by organisms that usually cause no or minor illness in immunocompetent individuals

            IMAGING

            • General Features

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    • Microscopic Features

                      CLINICAL ISSUES

                      • Presentation

                        • Demographics

                          • Natural History & Prognosis

                            • Treatment

                              DIAGNOSTIC CHECKLIST

                              • Consider

                                • Image Interpretation Pearls

                                  Selected References

                                  1. Sahn B et al: Features of intestinal disease associated with COVID-related multisystem inflammatory syndrome in children. J Pediatr Gastroenterol Nutr. 72(3):384-7, 2021
                                  2. Amann SO et al: Common variable immunodeficiency enteropathy with chronic giardiasis. Mayo Clin Proc. 95(6):1293-4, 2020
                                  3. Duffin C et al: Radiologic imaging of bowel infections. Semin Ultrasound CT MR. 41(1):33-45, 2020
                                  4. El Moheb M et al: Gastrointestinal complications in critically ill patients with and without COVID-19. JAMA. 324(18):1899-901, 2020
                                  5. Ignat M et al: Small bowel ischemia and SARS-CoV-2 infection: an underdiagnosed distinct clinical entity. Surgery. 168(1):14-6, 2020
                                  6. Kaafarani HMA et al: Gastrointestinal complications in critically ill patients with COVID-19. Ann Surg. 272(2):e61-2, 2020
                                  7. Wang C et al: Multifocal tuberculosis simulating a cancer-a case report. BMC Infect Dis. 20(1):495, 2020
                                  8. da Rocha EL et al: Abdominal tuberculosis: a radiological review with emphasis on computed tomography and magnetic resonance imaging findings. Radiol Bras. 48(3):181-91, 2015
                                  9. Dave M et al: Opportunistic infections due to inflammatory bowel disease therapy. Inflamm Bowel Dis. 20(1):196-212, 2014
                                  10. Pariente B et al: Review article: why, when and how to de-escalate therapy in inflammatory bowel diseases. Aliment Pharmacol Ther. 40(4):338-53, 2014
                                  11. Curkovic I et al: Risks of inflammatory bowel disease treatment with glucocorticosteroids and aminosalicylates. Dig Dis. 31(3-4):368-73, 2013
                                  12. Florescu DF et al: Opportunistic viral infections in intestinal transplantation. Expert Rev Anti Infect Ther. 11(4):367-81, 2013
                                  13. Tonolini M et al: Acute HIV-related gastrointestinal disorders and complications in the antiretroviral era: spectrum of cross-sectional imaging findings. Abdom Imaging. 38(5):994-1004, 2013
                                  14. Werneck-Silva AL et al: Gastroduodenal opportunistic infections and dyspepsia in HIV-infected patients in the era of highly active antiretroviral therapy. J Gastroenterol Hepatol. 24(1):135-9, 2009
                                  15. Hampton DD et al: Inflammatory bowel disease following solid organ transplantation. Clin Immunol. 128(3):287-93, 2008
                                  16. Ishida T et al: The management of gastrointestinal infections caused by cytomegalovirus. J Gastroenterol. 38(7):712-3, 2003
                                  17. Koh DM et al: Abdominal computed tomographic findings of Mycobacterium tuberculosis and Mycobacterium avium intracellulare infection in HIV seropositive patients. Can Assoc Radiol J. 54(1):45-50, 2003
                                  18. Streetz KL et al: Acute CMV-colitis in a patient with a history of ulcerative colitis. Scand J Gastroenterol. 38(1):119-22, 2003
                                  19. Brantsaeter AB et al: CMV disease in AIDS patients: incidence of CMV disease and relation to survival in a population-based study from Oslo. Scand J Infect Dis. 34(1):50-5, 2002
                                  20. Hunter PR et al: Epidemiology and clinical features of Cryptosporidium infection in immunocompromised patients. Clin Microbiol Rev. 15(1):145-54, 2002
                                  21. Masur H et al: Guidelines for preventing opportunistic infections among HIV-infected persons--2002. Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America. Ann Intern Med. 137(5 Pt 2):435-78, 2002
                                  22. Oldfield EC 3rd: Evaluation of chronic diarrhea in patients with human immunodeficiency virus infection. Rev Gastroenterol Disord. 2(4):176-88, 2002
                                  23. Ukarapol N et al: Cytomegalovirus-associated manifestations involving the digestive tract in children with human immunodeficiency virus infection. J Pediatr Gastroenterol Nutr. 35(5):669-73, 2002
                                  24. von Reyn CF et al: Sources of disseminated Mycobacterium avium infection in AIDS. J Infect. 44(3):166-70, 2002
                                  25. Huh JJ et al: Mycobacterium avium complex peritonitis in an AIDS patient. Scand J Infect Dis. 33(12):936-8, 2001
                                  26. Pollok RC: Viruses causing diarrhoea in AIDS. Novartis Found Symp. 238:276-83; discussion 283-8, 2001
                                  27. Chamberlain RS et al: Ileal perforation caused by cytomegalovirus infection in a critically ill adult. J Clin Gastroenterol. 30(4):432-5, 2000
                                  28. Clemente CM et al: Gastric cryptosporidiosis as a clue for the diagnosis of the acquired immunodeficiency syndrome. Arq Gastroenterol. 37(3):180-2, 2000
                                  29. Wallace MR et al: Gastrointestinal manifestations of HIV infection. Curr Gastroenterol Rep. 2(4):283-93, 2000
                                  30. Drew WL et al: Cytomegalovirus: disease syndromes and treatment. Curr Clin Top Infect Dis. 19:16-29, 1999
                                  31. Lumadue JA et al: A clinicopathologic analysis of AIDS-related cryptosporidiosis. AIDS. 12(18):2459-66, 1998
                                  32. Manabe YC et al: Cryptosporidiosis in patients with AIDS: correlates of disease and survival. Clin Infect Dis. 27(3):536-42, 1998
                                  33. Rossi P et al: Gastric involvement in AIDS associated cryptosporidiosis. Gut. 43(4):476-7, 1998
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Clinical Issues

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Definitions

                                              • Symptomatic gastrointestinal (GI) infection of immunocompromised host by organisms that usually cause no or minor illness in immunocompetent individuals

                                            IMAGING

                                            • General Features

                                              • Imaging Recommendations

                                                DIFFERENTIAL DIAGNOSIS

                                                  PATHOLOGY

                                                  • General Features

                                                    • Microscopic Features

                                                      CLINICAL ISSUES

                                                      • Presentation

                                                        • Demographics

                                                          • Natural History & Prognosis

                                                            • Treatment

                                                              DIAGNOSTIC CHECKLIST

                                                              • Consider

                                                                • Image Interpretation Pearls

                                                                  Selected References

                                                                  1. Sahn B et al: Features of intestinal disease associated with COVID-related multisystem inflammatory syndrome in children. J Pediatr Gastroenterol Nutr. 72(3):384-7, 2021
                                                                  2. Amann SO et al: Common variable immunodeficiency enteropathy with chronic giardiasis. Mayo Clin Proc. 95(6):1293-4, 2020
                                                                  3. Duffin C et al: Radiologic imaging of bowel infections. Semin Ultrasound CT MR. 41(1):33-45, 2020
                                                                  4. El Moheb M et al: Gastrointestinal complications in critically ill patients with and without COVID-19. JAMA. 324(18):1899-901, 2020
                                                                  5. Ignat M et al: Small bowel ischemia and SARS-CoV-2 infection: an underdiagnosed distinct clinical entity. Surgery. 168(1):14-6, 2020
                                                                  6. Kaafarani HMA et al: Gastrointestinal complications in critically ill patients with COVID-19. Ann Surg. 272(2):e61-2, 2020
                                                                  7. Wang C et al: Multifocal tuberculosis simulating a cancer-a case report. BMC Infect Dis. 20(1):495, 2020
                                                                  8. da Rocha EL et al: Abdominal tuberculosis: a radiological review with emphasis on computed tomography and magnetic resonance imaging findings. Radiol Bras. 48(3):181-91, 2015
                                                                  9. Dave M et al: Opportunistic infections due to inflammatory bowel disease therapy. Inflamm Bowel Dis. 20(1):196-212, 2014
                                                                  10. Pariente B et al: Review article: why, when and how to de-escalate therapy in inflammatory bowel diseases. Aliment Pharmacol Ther. 40(4):338-53, 2014
                                                                  11. Curkovic I et al: Risks of inflammatory bowel disease treatment with glucocorticosteroids and aminosalicylates. Dig Dis. 31(3-4):368-73, 2013
                                                                  12. Florescu DF et al: Opportunistic viral infections in intestinal transplantation. Expert Rev Anti Infect Ther. 11(4):367-81, 2013
                                                                  13. Tonolini M et al: Acute HIV-related gastrointestinal disorders and complications in the antiretroviral era: spectrum of cross-sectional imaging findings. Abdom Imaging. 38(5):994-1004, 2013
                                                                  14. Werneck-Silva AL et al: Gastroduodenal opportunistic infections and dyspepsia in HIV-infected patients in the era of highly active antiretroviral therapy. J Gastroenterol Hepatol. 24(1):135-9, 2009
                                                                  15. Hampton DD et al: Inflammatory bowel disease following solid organ transplantation. Clin Immunol. 128(3):287-93, 2008
                                                                  16. Ishida T et al: The management of gastrointestinal infections caused by cytomegalovirus. J Gastroenterol. 38(7):712-3, 2003
                                                                  17. Koh DM et al: Abdominal computed tomographic findings of Mycobacterium tuberculosis and Mycobacterium avium intracellulare infection in HIV seropositive patients. Can Assoc Radiol J. 54(1):45-50, 2003
                                                                  18. Streetz KL et al: Acute CMV-colitis in a patient with a history of ulcerative colitis. Scand J Gastroenterol. 38(1):119-22, 2003
                                                                  19. Brantsaeter AB et al: CMV disease in AIDS patients: incidence of CMV disease and relation to survival in a population-based study from Oslo. Scand J Infect Dis. 34(1):50-5, 2002
                                                                  20. Hunter PR et al: Epidemiology and clinical features of Cryptosporidium infection in immunocompromised patients. Clin Microbiol Rev. 15(1):145-54, 2002
                                                                  21. Masur H et al: Guidelines for preventing opportunistic infections among HIV-infected persons--2002. Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America. Ann Intern Med. 137(5 Pt 2):435-78, 2002
                                                                  22. Oldfield EC 3rd: Evaluation of chronic diarrhea in patients with human immunodeficiency virus infection. Rev Gastroenterol Disord. 2(4):176-88, 2002
                                                                  23. Ukarapol N et al: Cytomegalovirus-associated manifestations involving the digestive tract in children with human immunodeficiency virus infection. J Pediatr Gastroenterol Nutr. 35(5):669-73, 2002
                                                                  24. von Reyn CF et al: Sources of disseminated Mycobacterium avium infection in AIDS. J Infect. 44(3):166-70, 2002
                                                                  25. Huh JJ et al: Mycobacterium avium complex peritonitis in an AIDS patient. Scand J Infect Dis. 33(12):936-8, 2001
                                                                  26. Pollok RC: Viruses causing diarrhoea in AIDS. Novartis Found Symp. 238:276-83; discussion 283-8, 2001
                                                                  27. Chamberlain RS et al: Ileal perforation caused by cytomegalovirus infection in a critically ill adult. J Clin Gastroenterol. 30(4):432-5, 2000
                                                                  28. Clemente CM et al: Gastric cryptosporidiosis as a clue for the diagnosis of the acquired immunodeficiency syndrome. Arq Gastroenterol. 37(3):180-2, 2000
                                                                  29. Wallace MR et al: Gastrointestinal manifestations of HIV infection. Curr Gastroenterol Rep. 2(4):283-93, 2000
                                                                  30. Drew WL et al: Cytomegalovirus: disease syndromes and treatment. Curr Clin Top Infect Dis. 19:16-29, 1999
                                                                  31. Lumadue JA et al: A clinicopathologic analysis of AIDS-related cryptosporidiosis. AIDS. 12(18):2459-66, 1998
                                                                  32. Manabe YC et al: Cryptosporidiosis in patients with AIDS: correlates of disease and survival. Clin Infect Dis. 27(3):536-42, 1998
                                                                  33. Rossi P et al: Gastric involvement in AIDS associated cryptosporidiosis. Gut. 43(4):476-7, 1998