Cyclospora cayetanensis

Background

Epidemiology

• Worldwide distribution; endemic in developing countries with outbreaks in developed countries
• Acquired via contaminated food or water, especially raspberries, watercress, lettuce, basil, cilantro, etc.

Life Cycle

• Oocysts are quite resistant, and require sporulation in the environment before they are infectious
  • Each contains two sporocysts, each of which in turn contains two sporozoites

Clinical Presentation

• Primarily causes an opportunistic infection
• Causes an acute or chronic diarrhea
  • Usually present sooner than, for example, Giardia lablia, since they're more unwell
• More inflammatory than some of the other intestinal protozoa, with more fevers and malaise

Diagnosis

• Diagnosed with stool acid-fast staining, often requiring multiple samples

Management

• Treated with trimethoprim-sulfamethoxazole DS po bid for 7 to 10 days
  • Alternative: ciprofloxacin 500 mg po bid for 7 days