Cyclosporiasis natural history, complications and prognosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Cyclosporiasis}} | {{Cyclosporiasis}} | ||
{{CMG}}; {{AE}} {{JS}} | |||
{{CMG}} | |||
==Overview== | ==Overview== | ||
Manifestations of cyclosporiasis vary according to the endemicity of the country. Initial symptoms occur about 7 days after the ingestion of bacteria in contaminated food or water. If left untreated, these may persist from weeks to months. [[Symptoms]] may include: [[fever]]; [[anorexia]]; [[nausea]]; [[fatigue]]; [[abdominal cramping]]; and [[diarrhea]]. Younger and elderly patients usually experience more severe and prolonged symptoms. Although rare, potential complications include: [[malabsorption]]; [[cholecystitis]]; [[Guillain-Barré syndrome]]; and [[Reiter's syndrome]]. This infection is not life threatening, however, if untreated, severe cases of [[diarrhea]] may lead to [[dehydration]] and electrolyte imbalance, which may compromise the prognosis. | |||
==Natural History== | ==Natural History== | ||
Patients with cyclosporiasis may be [[asymptomatic]], or present only with milder and short lasting forms of the disease, particularly those who live in [[endemic]] areas.<ref name=CDC>{{cite web | title = Cyclosporiasis | url = http://www.cdc.gov/parasites/cyclosporiasis/biology.html }}</ref> Symptomatic disease is more common in non endemic regions. For patients who develop [[symptoms]] following the [[ingestion]] of sporulated [[oocysts]] of ''[[C. cayetanensis]]'', the typical [[incubation period]] is about 7 days.<ref name="pmid9605784">{{cite journal| author=Fleming CA, Caron D, Gunn JE, Barry MA| title=A foodborne outbreak of Cyclospora cayetanensis at a wedding: clinical features and risk factors for illness. | journal=Arch Intern Med | year= 1998 | volume= 158 | issue= 10 | pages= 1121-5 | pmid=9605784 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9605784 }} </ref><ref name="pmid9164810">{{cite journal| author=Herwaldt BL, Ackers ML| title=An outbreak in 1996 of cyclosporiasis associated with imported raspberries. The Cyclospora Working Group. | journal=N Engl J Med | year= 1997 | volume= 336 | issue= 22 | pages= 1548-56 | pmid=9164810 | doi=10.1056/NEJM199705293362202 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9164810 }} </ref> Cyclosporiasis commonly presents with the following [[symptoms]]:<ref name="pmid10451156">{{cite journal| author=Connor BA, Reidy J, Soave R| title=Cyclosporiasis: clinical and histopathologic correlates. | journal=Clin Infect Dis | year= 1999 | volume= 28 | issue= 6 | pages= 1216-22 | pmid=10451156 | doi=10.1086/514780 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10451156 }} </ref><ref name="pmid9605784">{{cite journal| author=Fleming CA, Caron D, Gunn JE, Barry MA| title=A foodborne outbreak of Cyclospora cayetanensis at a wedding: clinical features and risk factors for illness. | journal=Arch Intern Med | year= 1998 | volume= 158 | issue= 10 | pages= 1121-5 | pmid=9605784 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9605784 }} </ref><ref name="pmid9164810">{{cite journal| author=Herwaldt BL, Ackers ML| title=An outbreak in 1996 of cyclosporiasis associated with imported raspberries. The Cyclospora Working Group. | journal=N Engl J Med | year= 1997 | volume= 336 | issue= 22 | pages= 1548-56 | pmid=9164810 | doi=10.1056/NEJM199705293362202 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9164810 }} </ref><ref name="pmid9395371">{{cite journal| author=Ortega YR, Nagle R, Gilman RH, Watanabe J, Miyagui J, Quispe H et al.| title=Pathologic and clinical findings in patients with cyclosporiasis and a description of intracellular parasite life-cycle stages. | journal=J Infect Dis | year= 1997 | volume= 176 | issue= 6 | pages= 1584-9 | pmid=9395371 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9395371 }} </ref><ref name="pmid1928575">{{cite journal| author=Shlim DR, Cohen MT, Eaton M, Rajah R, Long EG, Ungar BL| title=An alga-like organism associated with an outbreak of prolonged diarrhea among foreigners in Nepal. | journal=Am J Trop Med Hyg | year= 1991 | volume= 45 | issue= 3 | pages= 383-9 | pmid=1928575 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1928575 }} </ref> | |||
*[[Anorexia]] | |||
*[[Nausea]] | |||
*[[Flatulence]] | |||
*[[Fatigue]] | |||
*[[Abdominal cramping]] | |||
*[[Diarrhea]] | |||
*Low-grade [[fever]] | |||
< | *[[Weight loss]] | ||
Without treatment, patients with cyclosporiasis may have symptoms for several weeks to several months. Some of these [[symptoms]], such as [[diarrhea]], can return, and others, such as [[muscle aches]] and [[fatigue]], may continue after the gastrointestinal manifestations have resolved.<ref name=CDC>{{cite web | title = Cyclosporiasis | url = http://www.cdc.gov/parasites/cyclosporiasis/biology.html }}</ref> | |||
In general, children and elderly patients experience more severe [[symptoms]] of cyclosporiasis. | |||
--> | Symptoms are also more severe and prolonged in [[HIV]]-positive patients. <ref name="pmid1928575">{{cite journal| author=Shlim DR, Cohen MT, Eaton M, Rajah R, Long EG, Ungar BL| title=An alga-like organism associated with an outbreak of prolonged diarrhea among foreigners in Nepal. | journal=Am J Trop Med Hyg | year= 1991 | volume= 45 | issue= 3 | pages= 383-9 | pmid=1928575 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1928575 }} </ref><ref name="pmid8589126">{{cite journal| author=Sifuentes-Osornio J, Porras-Cortés G, Bendall RP, Morales-Villarreal F, Reyes-Terán G, Ruiz-Palacios GM| title=Cyclospora cayetanensis infection in patients with and without AIDS: biliary disease as another clinical manifestation. | journal=Clin Infect Dis | year= 1995 | volume= 21 | issue= 5 | pages= 1092-7 | pmid=8589126 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8589126 }} </ref><ref name="pmid16533995">{{cite journal| author=Sancak B, Akyon Y, Ergüven S| title=Cyclospora infection in five immunocompetent patients in a Turkish university hospital. | journal=J Med Microbiol | year= 2006 | volume= 55 | issue= Pt 4 | pages= 459-62 | pmid=16533995 | doi=10.1099/jmm.0.46279-0 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16533995 }} </ref> | ||
==Complications== | ==Complications== | ||
< | Although rare, complications from cyclosporiasis may include:<ref name="pmid8589126">{{cite journal| author=Sifuentes-Osornio J, Porras-Cortés G, Bendall RP, Morales-Villarreal F, Reyes-Terán G, Ruiz-Palacios GM| title=Cyclospora cayetanensis infection in patients with and without AIDS: biliary disease as another clinical manifestation. | journal=Clin Infect Dis | year= 1995 | volume= 21 | issue= 5 | pages= 1092-7 | pmid=8589126 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8589126 }} </ref><ref name="pmid11177324">{{cite journal| author=de Górgolas M, Fortés J, Fernández Guerrero ML| title=Cyclospora cayetanensis Cholecystitis in a patient with AIDS. | journal=Ann Intern Med | year= 2001 | volume= 134 | issue= 2 | pages= 166 | pmid=11177324 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11177324 }} </ref> | ||
*[[Malabsorption]] | |||
*[[Cholecystitis]] | |||
*[[Guillain-Barré syndrome]]<ref name="pmid9572253">{{cite journal| author=Richardson RF, Remler BF, Katirji B, Murad MH| title=Guillain-Barré syndrome after Cyclospora infection. | journal=Muscle Nerve | year= 1998 | volume= 21 | issue= 5 | pages= 669-71 | pmid=9572253 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9572253 }} </ref> | |||
*[[Reiter's syndrome]]<ref name="pmid11384527">{{cite journal| author=Connor BA, Johnson EJ, Soave R| title=Reiter syndrome following protracted symptoms of Cyclospora infection. | journal=Emerg Infect Dis | year= 2001 | volume= 7 | issue= 3 | pages= 453-4 | pmid=11384527 | doi=10.3201/eid0703.010317 | pmc=PMC2631790 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11384527 }} </ref> | |||
==Prognosis== | ==Prognosis== | ||
In general, infection with ''[[C. cayetanensis]]'' is not a life-threatening condition. However, untreated patients may experience more severe forms of the disease, with severe and prolonged [[diarrhea]], which may lead to important [[dehydration]] and [[electrolyte imbalance]], that may have a poor prognosis.<ref name=CDC>{{cite web | title = Cyclosporiasis | url = http://www.cdc.gov/parasites/cyclosporiasis/biology.html }}</ref> | |||
==References == | ==References == | ||
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{{WS}} | {{WS}} | ||
[[Category:Disease]] | [[Category:Disease]] | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Manifestations of cyclosporiasis vary according to the endemicity of the country. Initial symptoms occur about 7 days after the ingestion of bacteria in contaminated food or water. If left untreated, these may persist from weeks to months. Symptoms may include: fever; anorexia; nausea; fatigue; abdominal cramping; and diarrhea. Younger and elderly patients usually experience more severe and prolonged symptoms. Although rare, potential complications include: malabsorption; cholecystitis; Guillain-Barré syndrome; and Reiter's syndrome. This infection is not life threatening, however, if untreated, severe cases of diarrhea may lead to dehydration and electrolyte imbalance, which may compromise the prognosis.
Natural History
Patients with cyclosporiasis may be asymptomatic, or present only with milder and short lasting forms of the disease, particularly those who live in endemic areas.[1] Symptomatic disease is more common in non endemic regions. For patients who develop symptoms following the ingestion of sporulated oocysts of C. cayetanensis, the typical incubation period is about 7 days.[2][3] Cyclosporiasis commonly presents with the following symptoms:[4][2][3][5][6]
Without treatment, patients with cyclosporiasis may have symptoms for several weeks to several months. Some of these symptoms, such as diarrhea, can return, and others, such as muscle aches and fatigue, may continue after the gastrointestinal manifestations have resolved.[1]
In general, children and elderly patients experience more severe symptoms of cyclosporiasis.
Symptoms are also more severe and prolonged in HIV-positive patients. [6][7][8]
Complications
Although rare, complications from cyclosporiasis may include:[7][9]
Prognosis
In general, infection with C. cayetanensis is not a life-threatening condition. However, untreated patients may experience more severe forms of the disease, with severe and prolonged diarrhea, which may lead to important dehydration and electrolyte imbalance, that may have a poor prognosis.[1]
References
- ↑ 1.0 1.1 1.2 "Cyclosporiasis".
- ↑ 2.0 2.1 Fleming CA, Caron D, Gunn JE, Barry MA (1998). "A foodborne outbreak of Cyclospora cayetanensis at a wedding: clinical features and risk factors for illness". Arch Intern Med. 158 (10): 1121–5. PMID 9605784.
- ↑ 3.0 3.1 Herwaldt BL, Ackers ML (1997). "An outbreak in 1996 of cyclosporiasis associated with imported raspberries. The Cyclospora Working Group". N Engl J Med. 336 (22): 1548–56. doi:10.1056/NEJM199705293362202. PMID 9164810.
- ↑ Connor BA, Reidy J, Soave R (1999). "Cyclosporiasis: clinical and histopathologic correlates". Clin Infect Dis. 28 (6): 1216–22. doi:10.1086/514780. PMID 10451156.
- ↑ Ortega YR, Nagle R, Gilman RH, Watanabe J, Miyagui J, Quispe H; et al. (1997). "Pathologic and clinical findings in patients with cyclosporiasis and a description of intracellular parasite life-cycle stages". J Infect Dis. 176 (6): 1584–9. PMID 9395371.
- ↑ 6.0 6.1 Shlim DR, Cohen MT, Eaton M, Rajah R, Long EG, Ungar BL (1991). "An alga-like organism associated with an outbreak of prolonged diarrhea among foreigners in Nepal". Am J Trop Med Hyg. 45 (3): 383–9. PMID 1928575.
- ↑ 7.0 7.1 Sifuentes-Osornio J, Porras-Cortés G, Bendall RP, Morales-Villarreal F, Reyes-Terán G, Ruiz-Palacios GM (1995). "Cyclospora cayetanensis infection in patients with and without AIDS: biliary disease as another clinical manifestation". Clin Infect Dis. 21 (5): 1092–7. PMID 8589126.
- ↑ Sancak B, Akyon Y, Ergüven S (2006). "Cyclospora infection in five immunocompetent patients in a Turkish university hospital". J Med Microbiol. 55 (Pt 4): 459–62. doi:10.1099/jmm.0.46279-0. PMID 16533995.
- ↑ de Górgolas M, Fortés J, Fernández Guerrero ML (2001). "Cyclospora cayetanensis Cholecystitis in a patient with AIDS". Ann Intern Med. 134 (2): 166. PMID 11177324.
- ↑ Richardson RF, Remler BF, Katirji B, Murad MH (1998). "Guillain-Barré syndrome after Cyclospora infection". Muscle Nerve. 21 (5): 669–71. PMID 9572253.
- ↑ Connor BA, Johnson EJ, Soave R (2001). "Reiter syndrome following protracted symptoms of Cyclospora infection". Emerg Infect Dis. 7 (3): 453–4. doi:10.3201/eid0703.010317. PMC 2631790. PMID 11384527.