       Document 0427
 DOCN  M9610427
 TI    Stimulated duodenal/bile juice aspiration for diagnosis of enteric
       pathogens in HIV-infected patients.
 DT    9601
 AU    Franzen C; Salzberger B; Fatkenheuer G; Ziegenhagen D; Cornely O; Diehl
       V; Schrappe M; Department of Internal Medicine I, University of
       Cologne,; Germany.
 SO    J Clin Gastroenterol. 1995 Jul;21(1):33-7. Unique Identifier : AIDSLINE
       MED/96004428
 AB    Gastrointestinal and biliary abnormalities are common in the acquired
       immunodeficiency syndrome. Although obviously related to opportunistic
       infections in many cases, often no infectious agent can be identified.
       The specific diagnosis depends on invasive methods such as endoscopic
       retrograde cholangiography and liver histology. To evaluate an
       alternative and less invasive first-line approach, we conducted a
       prospective study of microscopic examination of aspirated duodenal/bile
       juice, to try to identify microbial causes of human immunodeficiency
       virus (HIV)-related gastrointestinal and biliary tract disease.
       Sixty-four HIV-infected patients underwent upper gastrointestinal
       endoscopy with biopsies from the esophagus, stomach, and duodenum, and
       aspiration of stimulated duodenal/bile juice. Biopsies, duodenal/bile
       juice, and stool samples were examined for enteric pathogens.
       Twenty-seven intestinal infections were found in 22 of the 64 patients
       (34%), 12 (44%) of which were diagnosed by duodenal/bile juice
       examination. Seven of the 27 infections (26%) were diagnosed exclusively
       in duodenal/bile juice, whereas 5 were found in biopsies or stool
       samples as well. Twenty infections (74%) were demonstrated in intestinal
       biopsies and/or stool samples, 15 without any positive result in
       duodenal/bile juice. The proportion of patients with elevated
       alkaline-phosphatase and gamma-glutamyl-transpeptidase activities was
       higher in patients with infectious agents detected in duodenal/bile
       juice (5 of 11, 45%), than in patients with infectious agents found
       exclusively in intestinal biopsies and/or stool samples (2 of 11, 18%).
       Analysis of duodenal/bile juice is a simple, rapid, and effective method
       for the detection of enteral pathogens in HIV-related gastrointestinal
       and biliary dysfunction. It increases the diagnostic yield above the
       results of intestinal biopsies and stool examinations alone.
 DE    Adult  Aged  Bile/*MICROBIOLOGY/*PARASITOLOGY  Biliary Tract
       Diseases/*MICROBIOLOGY/PATHOLOGY/*PARASITOLOGY  Biopsy
       Feces/MICROBIOLOGY/PARASITOLOGY  Female  Gastrointestinal
       Diseases/*MICROBIOLOGY/PATHOLOGY/*PARASITOLOGY  Human  HIV
       Infections/*COMPLICATIONS  Intestines/PATHOLOGY  Male  Middle Age
       Prospective Studies  Suction  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

