Rare Case of Small Bowel Obstruction Secondary to Cryptosporidium in a Young Patient With Uncontrolled AIDS

Abstract

Small bowel obstruction is a common cause of abdominal pain and accounts for approximately 20% of surgical admissions related to abdominal pain. In the United States alone, there are over 300,000 admissions annually for small bowel obstruction and account for every 15 out of 100 admissions for abdominal pain. If treated appropriately with medical management, over 80% of cases resolve without life-threatening, long-term complications or the need for surgical intervention. The three most common causes including adhesions, tumors, and hernias account for the majority of cases. Less frequently reported causes include infections. We present the case of a 26-year-old male with a history of AIDS who was found to have a small bowel obstruction in the setting of active Cryptosporidium infection. Cryptosporidium is an opportunistic infection that more commonly affects immunocompromised hosts, especially those noncompliant with antiretroviral therapy. Our patient had an uncomplicated hospital course and made a full recovery due to early diagnosis and immediate intervention. We hope to make the medical community more aware of this rare and potentially life-threatening association given the rarity of such a presentation. Early diagnosis and intervention are critical to preventing morbidity and mortality.

Keywords: acquired immune deficiency syndrome; bowel wall edema; cryptosporidium; human immunodeficiency virus; small bowel obstruction.

Figure 1. Abdominal anterior-posterior X-ray film.

(A) and (B) demonstrate signs of small bowel obstruction with extensive dilations of the bowel and numerous air-fluid levels (marked by blue arrows). No signs of air are appreciated in the large intestine.