Cystoisospora belli: Difference between revisions
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Cystoisospora belli
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=== Epidemiology === |
=== Epidemiology === |
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* Worldwide, but more in tropical and subtropical areas |
* Worldwide, but more in tropical and subtropical areas |
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* Can have outbreaks with daycare, animal exposures |
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* Mostly associated with HIV infection, but can also cause a traveller's diarrhea |
* Mostly associated with HIV infection, but can also cause a traveller's diarrhea |
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* The merozoites go through asexual reproduction, eventually followed by sexual reproduction that results in development of an immature oocyst, which is shed |
* The merozoites go through asexual reproduction, eventually followed by sexual reproduction that results in development of an immature oocyst, which is shed |
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== Clinical |
== Clinical Manifestations == |
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* Incubation period of 1 week |
* Incubation period of [[Usual incubation period::1 week]] |
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* Watery diarrhea with abdominal cramping, malaise, anorexia, and weight loss |
* Watery diarrhea with abdominal cramping, malaise, anorexia, and weight loss |
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* Fever, if it occurs, is low-grade |
* Fever, if it occurs, is low-grade |
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* One of the only intestinal protozoa that can cause a peripheral '''eosinophilia''' |
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* Lasts 2 to 3 weeks, but can continue to shed oocysts for weeks after |
* Lasts 2 to 3 weeks, but can continue to shed oocysts for weeks after |
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* Includes HIV (CD4 <200) and chemotherapy |
* Includes HIV (CD4 <200) and chemotherapy |
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* Disease course may be more severe and may be chronic |
* Disease course may be more severe and may be chronic |
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* Can include hemorrhagic colitis |
* Can include '''hemorrhagic colitis''' |
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== Management == |
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* In HIV patients: |
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** [[Is treated by::Trimethoprim-sulfamethoxazole]] DS po qid for 10 days |
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** Alternative: [[Is treated by::ciprofloxacin]] 500 mg po bid for 7 days then three time weekly, [[Is treated by::pyrimethamine]] 75 mg po daily with folinic acid, or [[Is treated by::nitazoxanide]] |
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[[Category:Protozoa]] |
[[Category:Protozoa]] |
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[[Category:Gastrointestinal infections]] |
[[Category:Gastrointestinal infections]] |
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Latest revision as of 13:48, 5 August 2020
Background
Epidemiology
- Worldwide, but more in tropical and subtropical areas
- Can have outbreaks with daycare, animal exposures
- Mostly associated with HIV infection, but can also cause a traveller's diarrhea
Life Cycle
- Oocysts are shed into the environment
- Each contains one sporoblast
- Remain viable for months
- Oocysts sporulate in the environment before becoming infectious
- Sporoblasts dividing and maturing into two sporocysts, which in turn divide and mature into two sporozoites each
- The sporulated oocyst (containing four sporozoites) is ingested
- In the proximal small bowel, the sporozoites are released and develop into merozoites
- The merozoites go through asexual reproduction, eventually followed by sexual reproduction that results in development of an immature oocyst, which is shed
Clinical Manifestations
- Incubation period of 1 week
- Watery diarrhea with abdominal cramping, malaise, anorexia, and weight loss
- Fever, if it occurs, is low-grade
- One of the only intestinal protozoa that can cause a peripheral eosinophilia
- Lasts 2 to 3 weeks, but can continue to shed oocysts for weeks after
Immunocompromised patients
- Includes HIV (CD4 <200) and chemotherapy
- Disease course may be more severe and may be chronic
- Can include hemorrhagic colitis
Management
- In HIV patients:
- Trimethoprim-sulfamethoxazole DS po qid for 10 days
- Alternative: ciprofloxacin 500 mg po bid for 7 days then three time weekly, pyrimethamine 75 mg po daily with folinic acid, or nitazoxanide
