Page 118 - AIDSBK23C

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persistence can also manifest in malakoplakia, or the appearance of macrophages containing
target-like calcospherites called Michaelis-Gutman bodies.[505]
Vaccination against Pneumococcus in adults and H influenzae type b in children and
adults is a useful prevention strategy against these bacterial infections in adults with HIV
infection.[506] Trimethoprim-sulfamethoxazole used for Pneumocystis jiroveci (carinii)
pneumonia prophylaxis has been shown to also reduce the risk for bacterial infections. In
children, the use of intravenous IgG can help to prevent recurrent bacterial infections.[208]
Gastrointestinal bacterial infections can include Salmonella, Campylobacter, and
enteropathogenic E. coli involving the small intestine or Shigella, Campylobacter, Clostridium
difficile, Vibrio parahaemolyticus, Yersinia, and Aeromonas hydrophilia involving the colon.
Small intestinal infections are generally associated with large volumes of watery stool,
malabsorption, and wasting syndrome but no fever, occult blood, or fecal leukocytosis. Colonic
infections are characterized by frequent but small volume stools that may contain blood, have
abundant leukocytes, and be associated with painful bowel movements. Diagnosis is made via
microbiologic culture of stool or blood.[507]