HIV wasting and chronic diarrhoea — DTM&H MCQ

Instant feedback + full explanation. One question, done properly.

EasyHIV/AIDS in tropical settingsHIV wasting and chronic diarrhoeaDTM&H

A 45-year-old woman with advanced HIV in rural Zimbabwe has 6 weeks of watery diarrhoea and weight loss. Basic stool culture is negative. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Stool microscopy with modified acid-fast stain

Stool microscopy with modified acid-fast stain is the single best answer because modified acid-fast staining can identify coccidian parasites such as Cryptosporidium, Cystoisospora and Cyclospora. Widal serology is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that chronic watery diarrhoea in advanced HIV needs targeted opportunistic infection testing.

Reference: WHO consolidated HIV guidelines; WHO advanced HIV disease guidance; Manson's Tropical Diseases