Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chronic history of persistent, watery, non-bloody diarrhea, abdominal cramping, and significant weight loss. Symptoms have been refractory to standard anti-diarrheal therapy. History of immunocompromise (e.g., HIV/AIDS) or travel to endemic regions noted. Associated symptoms include anorexia, malaise, and occasional steatorrhea.
Clinical Examination Findings
General: Patient appears chronically ill, cachectic, or dehydrated. Abdomen: Soft, non-distended, with mild diffuse tenderness on deep palpation; no rebound or guarding. Bowel sounds: Hyperactive. Skin: Signs of mild to moderate dehydration (decreased turgor, dry mucous membranes). Vital signs: May show tachycardia or orthostatic hypotension if volume depletion is significant.
Treatment Protocol
Initiate Trimethoprim-Sulfamethoxazole (TMP-SMX) 160/800 mg orally twice daily for 10 days, followed by secondary prophylaxis in immunocompromised patients. Monitor for hypersensitivity reactions and renal function. Ensure adequate hydration and electrolyte replacement. Consider nutritional support for patients with significant malabsorption.