To the Editor.—
The recent publication by Green et al1 of two cases of acquired immunodeficiency syndrome (AIDS), in which the presenting features mimicked Crohn's disease, prompts us to report a similar case.
Report of a Case.—
A 46-year-old homosexual Frenchman, with multiple sexual partners, was admitted to the hospital because of diarrhea and fever. Stool examination revealed Gardia lamblia, Endolimax nana, and Pseudolimax butchilii, but no Salmonella, Shigella, and Campylobacter. Colonoscopy showed disseminated superficial linear or irregular ulcerations predominantly in the left colon. Pathological study of distal ileal and colonic biopsy specimens showed a mild inflammatory infiltration of the lamina propria by plasma cells, polymorphs and macrophages, rare signs of cryptitis, and colonic erosions. Neither ileal villous atrophy nor pathogens were observed. (A basophil body at the basal area of an enterocyte could have been a Coccidia, of Isospora belli type, but this finding was not confirmed by
Guerin J, Hoang C, Galian A, Lavergne A, Lebiez E, Bitoun A. Severe Diarrhea in a Patient With AIDS. JAMA. 1986;256(5):591. doi:10.1001/jama.1986.03380050059010