Cystisospora belli

Background

Epidemiology

• Worldwide, but more in tropical and subtropical areas
• 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