Cryptosporidium hominis

From IDWiki
Cryptosporidium hominis /
Revision as of 22:35, 9 October 2019 by Aidan (talk | contribs) ()

Microbiology

Epidemiology

  • Infects humans, but can also infect cows, mice, gnotobiotic pigs, and rarely other species
  • Transmitted fecal-oral via environmental contamination (such as recreational water), and can be spread person-to-person
    • Outbreaks are most commonly associated with drinking water, even when properly treated
  • Resistant to chlorination and can survive in the environment up to 6 months
  • Causes 2-6% of traveller's diarrhea

Life Cycle

  • Host ingests an oocyst (needing as few as 10 to cause disease)
  • The oocyst excyst in the stomach and proximal small bowel, releasing four sporozoites
  • Sporozoites bind to the intestinal epithelial cells and becomes vacuolized by the host cell membrane
  • In the parasitophorous vacuole, they reproduce asexually into further sporozoites, which divide into type I meronts
  • The type I meronts mature and release motile merozoites
  • The merozoites again attach to the intestinal epithelial cells
  • Merozoites then either reproduce asexually, as above, or sexually
    • Sexual reproduction involves a macrogamont and microgamont, which form a zygote
    • The zygote develops into an oocyst which contains four sporozoites
  • Oocysts may be involved in auto-inoculation (if thin-walled) or environmental contamination (if thick-walled)

Pathophysiology

  • Infection activates nuclear factor kappa B (NF-κB), which activates a large response
  • Infection results in increased permeability of the intestinal mucosa
  • T-cells are involved, with chronic infection in patients who are CD4-deplete

Clinical Presentation

  • Incubation period 7 days (range 1 to 30 days)
  • Watery diarrhea and malabsorption
  • Chronic infection more common in HIV with CD4 <180 and X-linked hyper-IgM
  • Associated with waterborne outbreaks of diarrhea