Cyclosporiasis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The symptoms usually start within one week of ingestion of contaminated food and water. If left untreated, symptoms may persist for weeks and months. This infection is not life threatening and is rarely associated with complications. People living in endemic area might have asymptomatic infections.
Natural History
- Symptoms of cyclosporiasis begin an average of 7 days (range, 2 days to > 2 weeks) after ingestion of sporulated oocysts (the infective form of the parasite).
- If a person ill with cyclosporiasis is not treated, symptoms can persist for several weeks to a month or more. Some symptoms, such as diarrhea, can return, and some symptoms, such as muscle aches and fatigue, may continue after the gastrointestinal symptoms have gone away.
- Infection is not usually life-threatening.
- Reported complications from Cyclospora infection are rare, but have included malabsorption and cholecystitis.
- Some people with Cyclospora infection experience no symptoms at all, particularly persons living in areas where the disease is endemic.
C. cayetanensis causes gastroenteritis, with the extent of the illness varying based on age, condition of the host, and size of the infectious dose. Symptoms include "watery diarrhea, loss of appetite, weight loss, abdominal bloating and cramping, increased flatulence, nausea, fatigue, and low-grade fever," though this can be augmented in more severe cases by vomiting, substantial weight loss, explosive diarrhea, and muscle aches. Typically, patients who come in with a persistent watery diarrhea lasting over several days may be suspected of harboring the disease, especially if they have traveled to a region where the protozoan is endemic. The incubation period in the host is typically around a week, and illness can last six weeks before self-limiting. Unless treated, illness may relapse. It is important to note here that the more severe forms of the disease can occur in immuno-compromised patients such as those with AIDS.