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1/ A 43-year-old male presents with right iliac fossa pain and bloody diarrhoea for
He had a fever, headache and myalgia the day before diarrhoeal illness. He is
passing liquid bloody stools 10 times daily.
He has a history of HIV and is on HAART. His CD4 count has been well controlled,
above 400 cells/μl.
What is the cause for his diarrhoea?
(Please select 1 option)
Campylobacter infection usually presents with bloody diarrhoea and
'pseudoappendicitis' (RIF pain). The patients often have a prodrome of fever,
headache and myalgia.Campylobacter takes around seven to 10 days to incubate.
Both Cryptosporidium and Cytomegalovirus are found in patients with CD4 count less
than 300 cells/μl. It causes chronic diarrhoea (more than four week's duration).
Patients commencing on antiretroviral medication may suffer with diarrhoea. It
usually is self-limiting, lasting two to four weeks, and would not be associated with
prodrome as in this case.
Given this gentleman's HIV status an infective cause for his diarrhoea is more likely