cyclosporiasis
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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)
- incubation period for infection is ~1 week
- 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
- many immunocompetent patients may experience a self-limited illness
- treatment is associated with faster disease resolution & less relapse[3]
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
- ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 18. American College of Physicians, Philadelphia 1998, 2012, 2015, 2018.
Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025 - ↑ 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
- ↑ 7.0 7.1 Frellick M Spike in Reported Cyclosporiasis Cases, CDC Warns. Medscape - Aug 07, 2017. http://www.medscape.com/viewarticle/883877
- ↑ 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