Case 6: A Migrant Worker with Abdominal Pain and Diarrhea

Case-Based Modules
Initial Evaluation
Dermatologic Manifestations
Oral Manifestations
OIs: Prophylaxis
OIs: Treatment
Antiretroviral Rx
Antiretroviral Rx: Resistance
Antiretroviral Rx: Adverse Effects
Drug-Drug Interactions
Postexposure Prophylaxis
Perinatal Transmission
Special Populations
Prevention for Positives
Challenging Unknowns
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Question | Discussion | References | CME Credit

You answered:

	The clinical manifestations and the modified acid-fast smear of the stool sample are consistent with a diagnosis of isosporiasis. Treatment should be initiated with trimethoprim-sulfamethoxazole (Bactrim, Septra).

This answer is correct. The clinical findings are non-specific, but are consistent with isosporiasis. The modified acid fast stain shows the characteristic elliptical Isosopora belli oocyst with visible internal sporocysts. The size of the oocyst (approximately 25 by 15 um) is consistent with I. belli and much too large for the round Cryptosporidium parvum oocyst (4-6 um wide). Trimethoprim-sulfamethoxazole is the treatment of choice for isosporiasis.

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