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Cryptosporidium
From WikEM
Contents
Background
- Protozoa causing diarrhea.
- Oocysts are 4-6 µm in diameter and exhibit partial acid-fast staining.
- Mostly commonly seen in HIV+
- Most common cause of chronic diarrhea in HIV patients.
Environmental Exposures
- Swim regularly in pools with insufficient sanitation.
- Hikers who drink untreated water.
- Handling infected cattle.
Clinical Features
Symptoms usually appear one week after infection which include:
- Fever
- Nausea/vomiting
- Abdominal pain/cramps
- Watery diarrhea
- Dehydration
- Weight loss
Differential Diagnosis
Acute diarrhea
Infectious
- Viral (e.g. rotavirus)
- Bacterial
- Campylobacter
- Shigella
- Salmonella (nontyphi)
- Escherichia coli
- E. coli 0157:H7
- Yersinia enterocolitica
- Vibrio cholerae
- Clostridium difficile
- Parasitic
- Giardia lamblia
- Cryptosporidium
- Entamoeba histolytica
- Cyclospora
- Toxin
Noninfectious
- GI Bleed
- Appendicitis
- Mesenteric Ischemia
- Diverticulitis
- Adrenal Crisis
- Thyroid Storm
- Toxicologic exposures
- Antibiotic or drug-associated
Watery Diarrhea
- Enterotoxigenic E. coli (most common cause of watery diarrhea)[1]
- Norovirus (often has prominent vomiting)
- Campylobacter
- Non-typhoidal Salmonella
- Enteroaggregative E. coli (EAEC)
- Enterotoxigenic Bacteroides fragilis
Traveler's Diarrhea
Evaluation
- No eosinophilia
- Stool acid-staining test
- Stool Culture
Management
- If non-sick appearing and not immunocompromised, medication often not needed.[2]
- Antiparasitics such as nitazoxanide for immunocompromised patients.[3]
- IV/PO hydration if dehydration present.
- If patient not on HAART therapy, consider contacting HIV/ID for initiating therapies.
- Admission if severe dehydration or electrolyte imbalance.
Disposition
- Most of these patient's can be discharged with close primary care/HIV follow up.
- If patient has electrolyte abnormalities or severely dehydrated consider observation placement vs admission for rehydration therapy
See Also
External Links
References
- ↑ Marx et al. “Cholera and Gastroenteritis caused by Noncholera Vibrio Species”. Rosen’s Emergency Medicine 8th edition vol 1 pg 1245-1246.
- ↑ White AC Jr. Cryptosporidiosis species. In: Mandell GL, Bennett JE, Dolin R, ed. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 209:3547-60.
- ↑ Lima AAM, Samie A, Guerrant RL. Cryptosporidiosis. In: Guerrant RL, Walker DH, Weller PF, eds. Tropical Infectious Diseases. Philadelphia, Pa: Elsevier-Churchill Livingstone; 2011:640-63.
Authors
Babak Missaghi, Aaron Snyder, Claire, Kevin Lu, Ross Donaldson, Neil Young
