A Case of HIV Infection Who Had Enterocolitis and Biliary Disease Due to Cyclospora after Traveling to India

A 48-year-old HIV-positive female had discontinued her hospital visits for about 1.5 years. Immediately after returning from a 1.5-month stay in India, she suffered from diarrhea about four times a day and, there-fore, visited our outpatient department. Liver dysfunction was noted on blood sampling, and bileduct dilatation was detected by magnetic resonance imaging (MRI)．Using feces, duodenum, and large intestine specimens, neon blue autofluorescence of the oocyst wall was detected under UV excitation with a fluorescence microscope. These specimens were molecularly biologically identified as Cyclospora cayetanensis using PCR sequencing. Since approval could not be obtained for the treatment of Cyclospora , only antiretroviral therapy (ART) was resumed. The CD4-positivity was above 180/ μ L for about 4 months, but alkaline phosphatase be-came exacerbated. Subsequently, the treatment of Cyclospora was started by prescribing trimethoprim/sul-famethoxazole (ST) (80/160mg, 4 tablets) for 10 days. The liver dysfunction and diarrhea were promptly alle-viated, and the bileduct dilatation was improved on MRI. In study, biliary disease and enteritis due Cyclospora effectively treated with an ST formulation. C. tract in HIV-infected cases in