{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:54:05Z","timestamp":1782921245849,"version":"3.54.5"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Construction Fund of Key Medical Disciplines of Hangzhou","award":["2025HZZD13"],"award-info":[{"award-number":["2025HZZD13"]}]},{"name":"Hangzhou Biomedical and Health Industry Development Support Science and Technology Project","award":["2023WJC173"],"award-info":[{"award-number":["2023WJC173"]}]},{"name":"Hangzhou Municipal Project of Medical and Health Technology","award":["A20240319"],"award-info":[{"award-number":["A20240319"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Co-infection with\n                    <jats:italic>Entamoeba histolytica<\/jats:italic>\n                    (\n                    <jats:italic>E. histolytica<\/jats:italic>\n                    ) and\n                    <jats:italic>Giardia lamblia<\/jats:italic>\n                    (\n                    <jats:italic>G. lamblia<\/jats:italic>\n                    ) is exceptionally rare reported in individuals with human immunodeficiency virus (HIV), despite both protozoa being well-recognized etiologic agents of intestinal disease in the general population. The overlapping clinical manifestations of protozoal infections and inflammatory bowel disease may pose significant diagnostic challenges, particularly in patients with advanced immunosuppression. We report the case of a 34-year-old man with advanced acquired immunodeficiency syndrome (AIDS) who presented with persistent mucopurulent bloody stools for 2\u202fmonths. Upon evaluation in our gastroenterology department, ulcerative colitis was initially considered; however, stool microscopy subsequently identified trophozoites of\n                    <jats:italic>E. histolytica<\/jats:italic>\n                    and\n                    <jats:italic>G. lamblia<\/jats:italic>\n                    . Colonoscopic assessment, supported by histopathological examination of biopsy specimens, confirmed\n                    <jats:italic>E. histolytica<\/jats:italic>\n                    infection. The patient was initiated on intravenous metronidazole in conjunction with antiretroviral therapy, leading to a gradual improvement of symptoms, with resolution of diarrhea within 10\u202fdays. This case highlights the importance of considering mixed protozoal infections in the differential diagnosis of chronic dysentery among immunocompromised patients. It further underscores the critical diagnostic value of repeated stool microscopy and histopathologic confirmation to avoid misdiagnosis and prevent delays in appropriate therapy.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1895591","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:40:37Z","timestamp":1782920437000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Mixed intestinal protozoal infection masquerading as ulcerative colitis in advanced AIDS: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Yan","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojin","family":"Ding","sequence":"additional","affiliation":[{"name":"Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenv","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aifang","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1016\/S0140-6736(03)12830-9","article-title":"Amoebiasis","volume":"361","author":"Stanley","year":"2003","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"574","DOI":"10.3390\/microbiolres13030040","article-title":"Prevalence of intestinal parasites in HIV\/AIDS-infected patients attending clinics in selected areas of the eastern cape","volume":"13","author":"Ifeoma","year":"2022","journal-title":"Microbiol Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e307","DOI":"10.1016\/S1473-3099(24)00739-4","article-title":"Chronic intestinal spirochaetosis and Giardia lamblia infection mimicking eosinophilic enterocolitis","volume":"25","author":"De Francesco","year":"2025","journal-title":"Lancet Infect 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