Diarrhea is common in resource-poor settings, especially where access to clean water is unreliable.^80–82 As previously noted, chronic diarrhea may be an indication for starting ART.⁸³ Common diarrhea-causing bacterial infections (such as that caused by Salmonella typhi) may be more aggressive and/or invasive in HIV-infected patients.⁸⁴ Diarrhea may also be the presenting feature of other systemic illnesses, especially in children. Management of diarrhea in HIV-infected patients depends on the severity of disease, the acuteness of the diarrhea, and the degree of immunosuppression. (Table 3.4)⁸⁵ The management approaches to acute and chronic diarrhea are summarized in Protocols 3.17 and 3.18. ^86–88 Adequate hydration with either oral rehydration solution or intravenous fluid resuscitation is essential. ⁸⁹ For acute diarrhea, systemic illnesses such as malaria must first be ruled out. If the patient is very ill, the care provider should not wait for culture results before initiating empiric therapy.

Source (Tables 3.4-3.6): Sande MA, Volberding PA, eds. The medical management of AIDS. 5^thed. Philadelphia, PA: W.B. Saunders and Company, 1997.