Spontaneous Resolution Of Cryptosporidiosis In A Child With Acquired Immunodeficiency Syndrome
American Journal of Diseases of Children 139(10): Oct 1985; 967
View Original Source →Abstract
We describe three patients with chronic autoimmune thrombocytopenia who exhibited transient remission during viral infection (varicella, hepatitis B, and influenza virus pneumopathy). In two patients, a male homosexual and a hemophiliac, thrombocytopenia was associated with AIDS-related complex. The third patient had classic idiopathic thrombocytopenic purpura. The mechanism of these rare remissions is discussed.
Case Details
Personal Characteristics
The patient, a male infant, was the 1,350 gram product of a 31-week gestation born to a non-drug-addicted mother (gravida 13/para 6/abortus 7).
Clinical Characteristics
At 8 months of age, he manifested failure to thrive, oral and cutaneous candidiasis unresponsive to nystatin, salmonellal gastroenteritis, recurrent otitis media, generalized lymphadenopathy, and hepatosplenomegaly. At 33 months of age the patient developed profuse, watery diarrhea (nine to ten stools per day) without blood or mucus. There was an 800 gram weight loss. He became febrile and developed herpetic gingivostomatitis, which subsided in six days.
Remission Characteristics
Candidiasis, lymphadenopathy, and hepatosplenomegaly have resolved, and he has had two isolated episodes of otitis media. Coincidentally, the patient had a spontaneous cessation in his diarrhea. Four follow-up stool specimens examined over a one month period using acid-fast stain were all negative.
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
The neonatal period was complicated and the infant underwent two double volume exchange transfusions, three packed red blood cell transfusions, and one platelet transfusion. He was managed with prophylactic administration of trimethoprim/sulfamethoxazole and high caloric formula supplement.
Additional Notes
The patient demonstrated antibodies to human T-cell lymphotropic virus type III (HTLV-III), but not to cytomegalovirus, adenovirus, or herpes simplex. Chest x-ray film revealed a persistent, nodular interstitial pneumonia.