A 32-year-old HIV-positive woman (CD4 count 150 cells/μL) presents with chronic watery diarrhea for 6 weeks, weight loss, and abdominal cramps. Stool modified acid-fast staining reveals oocysts of Cryptosporidium. She is not on ART. What is the definitive management?
- A Nitazoxanide for 14 days
- B Metronidazole for 10 days
- C Initiation of ART to restore immune function ✓
- D Ciprofloxacin for 7 days
Correct answer: C. Initiation of ART to restore immune function
Explanation
In HIV-associated cryptosporidiosis, the definitive treatment is immune reconstitution through ART. Nitazoxanide has limited efficacy in immunocompromised patients and is not curative without immune recovery. Metronidazole is for amebiasis and giardiasis, not cryptosporidiosis. Ciprofloxacin is used for bacterial causes like Campylobacter. With ART and CD4 recovery above 100 cells/μL, cryptosporidiosis typically resolves.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.