Cyclosporiasis (patient information)
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Overview
What are the symptoms of Cyclosporiasis?
Symptoms of cyclosporiasis start approximately 7 days following ingestion of water and food contaminated with sporulated oocysts. The most common symptom is watery diarrhea. Other symptoms include loss of appetite, cramping, flatulence, fatigue, low-grade fever, nausea and vomiting.
What causes Cyclosporiasis?
Cyclospora cayetanensis has been only recently identified as a single-celled coccidian parasite. It has been linked in the United States from fecally-contaminated imported raspberries and was virtually unknown before about 1990, but has been on the rise since. The health risk associated with the disease is usually confined to adult foreigners visiting endemic regions and acquiring the infection: this is why Cyclospora cayetanensis has been labeled as causing traveler's diarrhea. This species was placed in the Cyclospora genus because of the spherical shape of its sporocysts. The species name refers to the Cayetano Heredia University in Lima, Peru, where early epidemiological and taxonomic work was done.
Who is at highest risk?
People of all ages are at risk for infection. Persons living or traveling in tropical or subtropical regions may be at increased risk because cyclosporiasis is endemic in some developing countries. Foodborne outbreaks of cyclosporiasis in the United States and Canada have been linked to various types of imported fresh produce.
When to seek urgent medical care?
In case of endemic infection, people should seek medical care if watery diarrhea is noted.
Diagnosis
Health care providers should consider Cyclospora as a potential cause of prolonged diarrhea, particularly in patients with a history of recent travel to Cyclospora endemic areas. Testing for Cyclospora is not routinely done in most U.S. laboratories, even when stool is tested for parasites. Therefore, if indicated, health care providers should specifically request testing for Cyclospora. Cyclospora infection is diagnosed by examining stool specimens. Diagnosis can be difficult in part because even persons who are symptomatic might not shed enough oocysts in their stool to be readily detectable by laboratory examinations. Therefore, patients might need to submit several specimens collected on different days. Special techniques, such as acid-fast staining, are often used to make Cyclospora oocysts more visible under the microscope. In addition, Cyclospora oocysts are autofluorescent, meaning that when stool containing the parasite is viewed under an ultraviolet (UV) fluorescence microscope the parasite appears blue or green against a black background. Molecular diagnostic methods, such as polymerase chain reaction (PCR) analysis, are used to look for the parasite's DNA in the stool.[1]
Treatment options
Trimethoprim-sulfamethoxazole (TMP-SMX), or Bactrim, Septra, or Cotrim, is the treatment of choice.Most people who have healthy immune systems will recover without treatment. If not treated, the illness may last for a few days to a month or longer. Symptoms may seem to go away and then return one or more times (relapse). Anti-diarrheal medicine may help reduce diarrhea, but a health care provider should be consulted before such medicine is taken. People who are in poor health or who have weakened immune systems may be at higher risk for severe or prolonged illness.