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Cyclospora
From WikEM
Background
- one celled microscopic parasite that causes intestinal infection
- fecal-oral transmission
- endemic in tropical and subtropical regions
Signs/Symptoms
- watery (sometimes explosive) diarrhea, loss of appetite, weight loss, [[abdominal pain/cramps, bloating, increased flatus, nausea, and fatigue
- can last days to over a month
- In immunocompromised hosts, cyclospora may cause severe, intractable, voluminous diarrhea resembling cryptosporidiosis. Extraintestinal disease in patients with AIDS may include cholecystitis and disseminated infection.
Evaluation
- stool O&P
- Detection is facilitated by staining stool samples with modified acid-fast stain or modified safranin stain. Multiple (≥ 3) stool specimens may be needed because cyst secretion may be intermittent (2)
Management
- Bactrim: 160mg TMP and 800mg SMX PO BID for 7 to 10 days for cyclosporiasis or for 10 days. Children are given 5mg/kg TMP and 25mg/kg SMX PO BID for the same number of days.
- Immunocompromised patients may require higher doses and longer duration of treatment, and treatment of acute infection is usually followed by long-term suppressive therapy
References
- 1. U.S. Centers for Disease Control. Cyclosporiasis. Retrieved from http://www.cdc.gov/parasites/cyclosporiasis/gen_info/faqs.html
- 2. RD Pearson. "Cyclosporiasis and Cystoisosporiasis". The Merck Manual. Retrieved from http://www.merckmanuals.com/professional/infectious-diseases/intestinal-protozoa/cyclosporiasis-and-cystoisosporiasis
