Cyclosporiasis

• Cyclospora cayetanensis is the only species known to infect humans

• Cyclosporiasis is seen in three main epidemiologic settings

  • Sporadic cases in endemic areas (particularly Haiti, Guatemala, Peru, and Nepal)

  • Travelers to endemic areas

  • Food- or water-borne outbreaks in nonendemic areas, particularly in relation to importation of fresh produce

• Incubation period is approximately 7 days (range 2–14 days)

Clinical Findings

• May be asymptomatic

• Diarrhea

  • Can be mild to moderate self-limited diarrhea or cause protracted or severe

  • In immunocompetent persons, usually lasts 10–25 days but may be followed by a relapsing pattern that can last several months

  • Defined as 5–15 movements per day

  • Usually watery, sometimes explosive

  • Often accompanied by nausea, vomiting, abdominal cramping, and bloating

• Profound fatigue, anorexia, and myalgias have been reported

• Infection can be unusually severe in immunocompromised patients, especially those with HIV/AIDS

• Although the illness is self-limited, it may last for several weeks

Diagnosis

• Diagnosis is based on finding oocysts 8–10 mm in diameter on examination of stool specimens stained with acid-fast stain

• Polymerase chain reaction of stool is available at the Centers for Disease Control and Prevention and some reference laboratories

Treatment

• Trimethoprim-sulfamethoxazole for 7 days