II. Pathophysiology
- Coccidian Parasite in Eimeriidae family
- Organism: Cyclospora cayetanensis
- Infects the Small Intestine in humans
- Humans are the only known hosts
- Transmission via Cyclospora oocyst ingestion
- Waterborne Illness
- Endemic to some tropical and subtropical regions
- Foodborne Illness
- Fresh produce (outbreaks in U.S. and Canada)
- Infective dose is thought to be low (<100 oocysts)
- Fecal-oral transmission is unlikely
- Oocysts sporulate (over days to weeks) outside a host before they are once again infective
- Sporulation requires external Temperatures 72 to 90 F (22 to 32 C)
- Waterborne Illness
- Worldwide distribution
- Latin America
- Egypt
- Sub-Saharan Africa
- India
- Southeast Asia
- U.S. cases
- International travelers
- Ingesting contaminated fresh imported produce from endemic areas
- U.S. Outbreaks (e.g. contaminated salad greens) have occurred in spring, summer
- Course
- Incubation: 2-14 days (1 week on average)
- Variable course of a few days to months of illness
- More severe course (e.g. protracted Diarrhea) in Immunocompromised, or extremes of age
III. Symptoms
IV. Labs
- Cyclospora PCR (preferred)
- Test Sensitivity and Test Specificity approach 95%
-
Ova and Parasite (microscopy)
- Variable detection rates are typically low
- Detection requires 3 or more samples collected every 2 to 3 days
- Modified acid fast stain or UV microscopy may improve Test Sensitivity
V. Management
- Trimethoprim-Sulfamethoxazole DS (Septra, Bactrim)
- Immunocompetent
- Dose: 1 DS tab twice daily for 7 to 10 days
- Immunodeficiency or HIV
- Initial: 1 DS tab four times daily for 3 to 4 weeks
- Suppression may be needed with 1 DS tab three times weekly
- Immunocompetent
- Other agents (variably effective with high failure rates)
- Ciprofloxacin 500 mg twice daily for 7 days
- Nitazoxanide
VI. Complications
- Malabsorption
- Acalculous Cholecystitis (HIV patients)
- Guillain-Barre Syndrome
-
Reactive Arthritis (Reiter's Syndrome)
- Inflammatory Oligoarthritis
- Eye inflammation (Iritis, Episcleritis, Conjunctivitis)
- Urethritis
VII. Course
- Without treatment, may persist for months or follow a relapsing course
VIII. Resources
- CDC Cyclosporiasis
IX. References
- (2015) Sanford Guide to antimicrobials, accessed IOS app 5/11/2016
- Ortega (2010) Clin Microbiol Rev 23(1): 218-34 +PMID:20065331 [PubMed]
- Pyzocha (2023) Am Fam Physician 108(5): 487-93 [PubMed]
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Related Studies
Definition (MSH) | Infection with parasitic protozoa of the genus CYCLOSPORA. It is distributed globally and causes a diarrheal illness. Transmission is waterborne. |
Concepts | Disease or Syndrome (T047) |
MSH | D021866 |
ICD9 | 007.5 |
ICD10 | A07.4 |
SnomedCT | 240372001 |
LNC | LA10449-9 |
English | Cyclosporiasis, cyclosporiasis, cyclosporiasis (diagnosis), Cyclosporiasis [Disease/Finding], Cyclosporiases, Cyclosporiasis (disorder) |
Dutch | cyclosporiase, Cyclosporiasis |
Portuguese | Ciclosporiase, Ciclosporose, Ciclosporíase |
Japanese | サイクロスポラ症, サイクロスポラショウ |
Swedish | Cyklosporiasis |
Czech | cyklosporóza, cyclosporiasis, Cyklosporiáza |
Finnish | Syklosporiaasi |
Russian | TSIKLOSPORIAZ, ЦИКЛОСПОРИАЗ |
Spanish | cicloesporiasis (trastorno), ciclosporiasis (trastorno), cicloesporiasis, ciclosporiasis, Ciclosporosis, Ciclosporiosis, Ciclosporiasis |
Polish | Cyklosporiaza, Cyklosporioza, Zarażenie Cyclospora, Zarażenie Cyklosporą |
Hungarian | Cyclosporiasis |
Norwegian | Cyklosporainfeksjoner |
French | Cyclosporose, Infection à Cyclospora |
German | Cyclosporiasis |
Italian | Ciclosporiasi |
Ontology: Cyclospora cayetanensis (C0446189)
Concepts | Bacterium (T007) |
SnomedCT | 103561005 |
LNC | LP14898-8, MTHU002137 |
English | cyclospora cayetanesis, cyclospora cayetanensis, Cyclospora cayetanensis, Cyclospora cayetanesis, Cyclospora cayetanensis (organism), Cyclospora cayetanesis (organism) |
Spanish | Cyclospora cayetanensis, Cyclospora cayetanensis (organismo), Cyclospora cayetanesis, Cyclospora cayetanesis (organismo) |
Ontology: Cyclospora (C0522435)
Definition (MSHCZE) | Prvok patřící k střevním kokcidiím, vyvolává parazitární onemocnění střeva cyklosporiózu. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
Definition (MSH) | A genus of coccidian parasites in the family EIMERIIDAE. Cyclospora cayetanensis is pathogenic in humans, probably transmitted via the fecal-oral route, and causes nausea and diarrhea. |
Definition (CSP) | genus of coccidian parasites in the family Eimeriidae; Cyclospora cayetanensis is pathogenic in humans, probably transmitted via the fecal-oral route, and causes nausea and diarrhea. |
Concepts | Eukaryote (T204) |
MSH | D021744 |
SnomedCT | 103560006 |
LNC | LP32501-6 |
Swedish | Cyclospora |
English | Cyclospora, Cyclosporas, cyclospora, Genus: Cyclospora, Cyclospora (organism), Cyclospora, NOS |
Czech | Cyclospora, Cyclospora cayetanensis |
Finnish | Cyclospora |
Russian | TSIKLOSPORY, ЦИКЛОСПОРЫ |
Polish | Cyklospora |
Norwegian | Cyclospora |
Spanish | Cyclospora (organismo), Cyclospora, SAI, género: Cyclospora, Cyclospora |
French | Cyclospora |
German | Cyclospora |
Italian | Cyclospora |
Dutch | Cyclospora |
Portuguese | Cyclospora |