II. Pathophysiology

  1. Coccidian Parasite in Eimeriidae family
  2. Organism: Cyclospora cayetanensis
    1. Infects the Small Intestine in humans
  3. Transmission via Cyclospora oocyst ingestion
    1. Waterborne Illness
      1. Endemic to some tropical and subtropical regions
    2. Foodborne Illness
      1. Fresh produce (outbreaks in U.S. and Canada)
    3. Fecal-oral transmission is unlikely
      1. Oocysts sporulate (over days to weeks) outside a host before they are once again infective
  4. Incubation: 2-14 days (1 week on average)

III. Symptoms

  1. Anorexia, weight loss and Fatigue
  2. Low-grade fever may be present
  3. Nausea (and in some cases Vomiting)
  4. Non-bloody Diarrhea (may be explosive)
  5. Abdominal cramping and bloating
  6. Excessive Flatus

IV. Labs

  1. Cyclospora PCR
  2. Ova and Parasite (microscopy)
    1. Variable detection rates
    2. Modified acid fast stain or UV microscopy may improve Test Sensitivity

V. Management

  1. Trimethoprim-Sulfamethoxazole DS (Septra, Bactrim)
    1. Immunocompetent
      1. Dose: 1 DS tab twice daily for 7-10 days
    2. Immunodeficiency or HIV
      1. Initial: 1 DS tab four times daily for 3-4 weeks
      2. Suppression may be needed with 1 DS tab three times weekly
  2. Other agents (variably effective)
    1. Ciprofloxacin 500 mg twice daily for 7 days
    2. Nitazoxanide

VI. Complications

  1. Reactive Arthritis (Reiter's Syndrome)
  2. Malabsorption
  3. Cholecystitis (HIV patients)

VII. Course

  1. Without treatment, may persist for months or follow a relapsing course

VIII. Resources

IX. References

  1. (2015) Sanford Guide to antimicrobials, accessed IOS app 5/11/2016
  2. Ortega (2010) Clin Microbiol Rev 23(1): 218-34 +PMID:20065331 [PubMed]

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Related Studies

Ontology: Cyclosporiasis (C0343398)

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
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
Polish Cyklospora
Norwegian Cyclospora
Spanish Cyclospora (organismo), Cyclospora, SAI, género: Cyclospora, Cyclospora
French Cyclospora
German Cyclospora
Italian Cyclospora
Dutch Cyclospora
Portuguese Cyclospora