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CyclosporiasisA07.3
Synonym(s)
Cyclosporiasis
HistoryThis section has been translated automatically.
Ashford, 1979
DefinitionThis section has been translated automatically.
Fecal-orally transmitted protozoan enteritis caused by Cyclospora cayetanensis.
PathogenThis section has been translated automatically.
Cyclospora cayetanensis, an intestinal parasite in humans, rodents, reptiles and monkeys. Infectious forms are the oocysts.
Occurrence/EpidemiologyThis section has been translated automatically.
- Epidemic and endemic protozoan infection.
- Occurs in USA, Canada, UK, Germany, Caribbean, Latin America and Asia.
- In humans (Nepal travellers) first described in 1985; initially described as "green algae like bodies" and thought to be relatives of cyanobacteria.
- Occurrence in regions with poor water supply and poor hygienic standards (e.g. outbreak in the USA in 1995 caused by raspberries imported from Guatemala or in Canada by imported Thai basil).
- Oocysts are resistant to chlorine.
Clinical featuresThis section has been translated automatically.
- The Integument is rarely involved. Lymphadenopathy can occur as part of the general symptoms. Parainfectious exanthema can occur especially in immunocompromised persons. The strong diarrhoea can cause short-term perianal eczema.
- Acute course: Mostly cramp-like pain in the upper abdomen and watery diarrhoea are an essential part of the symptoms. In rare cases asymptomatic or mild courses of the disease occur.
- Chronic course: Long lasting pain in the upper abdomen (up to years): difficult bowel movement, postprandial feeling of fullness, then massive defecation of mushy stools, pronounced tiredness with sudden falling asleep.
DiagnosisThis section has been translated automatically.
- Microscopy (oocysts): concentration methods for amoebae; staining: Kinyoun and modified Ziehl-Neelsen staining.
- PCR.
TherapyThis section has been translated automatically.
- Cotrimoxazole (Trimethoprim-Sulfamethoxazole [160 mg/800 mg], e.g. Cotrim forte): 2 times/day 1 tbl. p.o. for 7 days For HIV-infected persons double daily dose and subsequent maintenance therapy 3 times/week 1 tbl. p.o.
- Alternative therapies with ciprofloxacin and nitazoxanide are discussed.
ProphylaxisThis section has been translated automatically.
- Boiling water for 10 minutes kills oocysts.
- Drinking water and food hygiene.
- Toilet hygiene.
LiteratureThis section has been translated automatically.
- Ashford RW (1979) Occurrence of an undescribed coccidian in man in Papua New Guinea. Ann Trop Med Parasitol 73: 497-500