Cyclospora cayetanensis
From IDWiki
Background
Epidemiology
- Humans are the only known host
- Worldwide distribution; endemic in developing countries with outbreaks in developed countries
- Acquired via contaminated food or water, especially raspberries, watercress, lettuce, basil, cilantro, etc.
- Essentially, produce that is difficult to wash
- Outbreaks each summer
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 Manifestations
- Primarily causes an opportunistic infection
- Causes an acute or chronic diarrhea
- Usually present sooner than, for example, Giardia lamblia, since they're more unwell
- More inflammatory than some of the other intestinal protozoa, with more fevers and malaise
- Complications can include reactive arthritis and Guillain-Barré syndrome
Diagnosis
- Stool microscopy with stool acid-fast staining, often requiring multiple samples
- The oocytes are shed only intermittently, so need many stool samples to get adequate sensitivity
- PCR
Management
- Treated with trimethoprim-sulfamethoxazole DS po bid for 7 to 10 days
- Alternative: ciprofloxacin 500 mg po bid for 7 days
