A 45-year-old male with a history of HIV infection presents with diarrhea and severe dehydration. He reports having 6-8 watery bowel movements a day for the past month. He also complains of abdominal cramps. His last CD4 count six months ago was 100 cells/mm3. What could be the potential causes?
In an immunocompromised patient such as this, opportunistic infections should be considered. The most common cause of chronic diarrhea in patients with advanced HIV/AIDS is Cryptosporidium, but other pathogens such as Microsporidia, Giardia, and Cytomegalovirus should also be considered. Diagnostic workup should include stool microscopy and special stains to identify the specific organism.