Persistent Diarrhea

A 39-year-old male with a history of HIV, diagnosed 3 years ago, presents with persistent diarrhea for the past month. He reports watery, non-bloody stools occurring 6-8 times a day, along with abdominal cramping and fatigue. He is on antiretroviral therapy (ART) but admits to occasional nonadherence. His last CD4 count, two months ago, was 150 cells/µL. He denies recent travel, consumption of undercooked food, or exposure to sick contacts. On examination, his vitals are stable, but he appears dehydrated.

Questions

  1. Differential Diagnoses
    Based on the patient’s presentation, what are the potential differential diagnoses? Prioritize these diagnoses based on the patient’s clinical presentation and risk factors.
  2. Diagnostic Workup
    What diagnostic tests would you order to differentiate between these diagnoses? Explain the rationale for each test.
  3. Treatment Plan
    Develop a comprehensive treatment plan for the most likely diagnosis, considering the patient’s age, comorbidities, and potential side effects.
  4. Patient Education
    What important information should you provide to the patient and their family regarding the diagnosis, treatment, and prevention of further episodes?

For peer response answer this:

  • What if they noticed visual changes severe headaches or confusion recently?

What red flags would indicate the need for immediate referral to the emergency department?

Submission Instructions:

  • Your initial post should be at least 500 words, formatted, and cited in current APA style with support from at least 2 academic sources.
  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.
  • All replies must be constructive and use literature where possible.
  • Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
  • Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
  • You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

persistent diarrhea

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