cyclosporiasis
Jump to navigation
Jump to search
Etiology
Epidemiology
- recovered from patients in several countries, including USA
- disease is more common in the summer
- cause of traveler's diarrhea
- can cause outbreaks of diarrhea in filtered & chlorinated water
- 200 cases of cyclosporiasis in Iowa, Nebraska, Texas, & Wisconsin in 2013[4]
- outbreaks in Nebraska and Iowa 2013 linked to bagged salad & fresh cilantro grown in Mexico
- 206 cases May 1-Aug 7 from 27 states 2017[7][8] twice rate of 2016 (18 hospitalizations, no deaths)
Pathology
- oocysts pass unsporulated
- 1-2 weeks are required for sporulation
- each mature oocyst contains 2 sporocysts, each with 2 sporozoites
Clinical manifestations
- flu-like illness with nausea/vomiting, weight loss & explosive diarrhea
- watery diarrhea, bloating, flatulence, crampy abdominal pain
- nausea, anorexia, fever (occasional)
- symptoms last 1-3 weeks
Laboratory
- Cyclospora antigen in stool
- oocysts in stool
- nonrefractile spheres measuring 8-10 um containing a cluster of refractile globules enclosed within a membrane
- with trichrome stains, appear clear, round & somewhat wrinkled
- stain with acid fast stains
- auramine-O
- modified Kinyoun method
- autofluoresce bright green to intense blue under UV-epifluorescence
- numerous stool specimens may be necessary because Cyclospora oocysts are sometimes shed at low levels & intermittently[8]
- Cyclospora DNA
Management
- Bactrim DS (TMP/SMX), 1 PO BID for 7 days
- ciprofloxacin if sulfonamide allergy[3]
- HIV patients may experience relapse & require long-term maintenance therapy
More general terms
Additional terms
References
- ↑ Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 1281
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 1204
- ↑ Jump up to: 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 18. American College of Physicians, Philadelphia 1998, 2012, 2015, 2018.
- ↑ Jump up to: 4.0 4.1 FDA: Food. Posted July 22, 2013 FDA Investigates Multistate Outbreak of Cyclosporiasis http://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm361637.htm
- ↑ Physician's First Watch, August 1, 2013 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society (see CDC site) http://www.jwatch.org
- ↑ Centers for Disease Control and Prevention CDC) Parasites - Cyclosporiasis (Cyclospora Infection) Investigation of an Outbreak of Cyclosporiasis in the United States. Updated Oct 23, 2013 http://www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html
- ↑ Jump up to: 7.0 7.1 Frellick M Spike in Reported Cyclosporiasis Cases, CDC Warns. Medscape - Aug 07, 2017. http://www.medscape.com/viewarticle/883877
- ↑ Jump up to: 8.0 8.1 8.2 Centers for Disease Control and Prevention (CDC) Increase in Reported cases of Cyclospora cayetanensis Infection, United States, Summer 2017. CDC Health Alert Network. August 7, 2017, https://emergency.cdc.gov/han/han00405.asp