Cryptosporidial diarrhoea in AIDS and its treatment.

Of 234 patients with AIDS diagnosed at St. Stephen's Hospital between January 1981 and June 1987, 26 (11%) were found to have cryptosporidiosis. Stool examination was positive in all patients, but an average of three specimens (range 1-6) were required before a positive diagnosis was made. Other methods of diagnosis included jejunal and rectal biopsy and aspiration of the duodenal contents. Twenty three (89%) lived for six months from the time of diagnosis and 16 (60%) were alive at one year. Only five patients died as a direct result of cryptosporidial infection, while 10 other patients died from another complication of AIDS. Fifteen patients were enrolled in a prospective controlled study of erythromycin or spiramycin in the treatment of cryptosporidial diarrhoea. Most patients showed a significant response to antibiotic therapy but treatment was limited because of side effects. All patients responded to antidiarrhoeal agents, particularly long acting morphine sulphate. Three of our patients recently given zidovudine (AZT) have responded with a cessation of diarrhoea and cryptosporidia are no longer isolated from the stools.