ABSTRACT
Between 1990-1992 we performed colonoscopy and biopsy on 123 sequential patients with CDC Group IVC AIDS seen at Mulago Hospital, Kampala, who had persistent bloody diarrhea in excess on one month despite antibiotic treatment. Kaposi's sarcoma-like lesions were noted in 69 [56%]. The lesions were predominantly macular in morphology, localized to the rectosigmoid and ascending colon, and bled easily. Kaposi's sarcoma [KS] was confirmed histologically in 56 [81%] of these patients. Inability to confirm the histology in the remaining 13 patients was attributed to the submucosal location of KS, inaccessible to the biopsy forcepsd. All patients with colonic Kaposi's sarcoma also had KS in the lesions in the skin and/or mouth. Inflammatory and granulomatous abnormalities were noted in 103 patients, accompanied by non-specific histological changes. Stool pathogenes were identified as follows: Cryptosporidium 65 patients; Strongy-Ioides stercoralis 37 patients; Giardia lamblia 8 patients; Entameba histolytica 6 patients; and Ancylostoma 5 patients. Multiple pathogens were seen in some patients. There were no correlations between the individual pathogens, gross or microscopic abnormalities, and the Kaposi's sarcoma-like lesions. Colonic Kaposi's sarcoma was strongly associated with bloody diarrhea in AIDS patients in Uganda