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PubMed2004

Point prevalence of Cryptosporidium, Cyclospora, and Isospora infections in patients being evaluated for diarrhea.

From March to September 2001, 315 specimens from "nonrepeat" patients that were submitted for ova and parasite examination were stained using the Kinyoun modified acid-fast stain to detect the intestinal coccidians. Four patients (1.3%) were infected with coccidians, 2 with Cryptosporidium parvum and 2 with Cyclospora cayetanensis. No infections with Isospora belli were detected. In comparison, 15 patients (4.8%) had infections with one or more intestinal parasites detected by routine trichrome staining: 5 had Giardia lamblia; 2, Dientamoeba fragilis; 3, Strongyloides stercoralis; 1, Iodamoeba bütschlii; 3, Endolimax nana; 6, Blastocystis hominis; and 1, Entamoeba coli. Four patients were multiply infected. Coccidians made up 29% of the clinically significant parasitic infections. The coccidians were missed in all 4 cases because no special staining was ordered. Clinicians need to be reminded that additional tests should be ordered to fully evaluate patients with chronic diarrhea in which no diagnosis is found by routine testing.

Adolescent↗
PubMed2006

[High prevalence of Cyclospora cayetanensis among indigenous people in Bolivar State, Venezuela].

The intestinal coccidioses caused by Cryptosporidium parvum, Isospora belli, and Cyclospora cayetanensis are parasitoses of major medical importance, but many epidemiological aspects of these infections are still unknown in Bolívar State, Venezuela. To determine the prevalence of intestinal parasites and especially of intestinal coccidiosis, an indigenous population in San Antonio de Morichal was evaluated from July 2003 to April 2004. Stool samples obtained by spontaneous evacuation were preserved in potassium dichromate 2.5% and examined by the formalin-ether concentration method and Kinyoun staining. Of the 160 indigenous people examined, 92.5% (148 cases) were infected. Entamoeba coli (58.8%), Ascaris lumbricoides (38.8%), and Giardia lamblia (18.8%) were the most prevalent intestinal parasites. Coccidiosis prevalence was 13.1%, and cyclosporiasis was the most prevalent with 11.9% (19 cases). One subject with C. parvum oocysts and another with I. belli oocysts were diagnosed. There was no difference according to sex (p > 0.05) and age (chi2 = 5.6; f.g. = 6) among individuals infected with C. cayetanensis. Of these, two cases had only diarrhea. In conclusion, a high prevalence of intestinal coccidiosis infection was found among indigenous people from this community, with C. cayetanensis as the most prevalent infection.

Adolescent↗
PubMed2003

Cryptosporidium, Giardia, and Cyclospora in ancient Peruvians.

Twenty-two coprolites of human origin, collected from excavations along the north-central coast of Peru, were examined using fluorescent microscopy for the presence of fecal parasites, with emphasis on Cryptosporidium sp., Giardia sp., and Cyclospora sp. Three samples were positive. One coprolite dated between ca. 2,375 and 1,525 BC contained Giardia sp. cysts. This coprolite corresponded to the Peruvian preceramic period. Another positive coprolite ca. AD 770-830 corresponded to Epoch 3 of the Middle Horizon and contained Cryptosporidium sp. oocysts. The third positive coprolite (corresponding to the Middle Horizon. ca. AD 500-900) contained Giardia sp. cysts. This report demonstrates that Giardia sp. and Cryptosporidium sp. were present in Peruvian coastal populations for at least 4,300 and 1,100 BP.

Animals↗
PubMed2000

Isolation of Cyclospora oocysts from fruits and vegetables using lectin-coated paramagnetic beads.

Published techniques for recovering parasites from fruit and vegetables are generally inadequate, with low and variable recovery efficiencies. Herein, we describe an improved method for analyzing fruit and vegetables for Cyclospora oocysts. The technique includes washing procedures, sonication, and separation using lectin-coated paramagnetic beads. Identification is by microscopy (differential interference contrast and fluorescence). Oocyst recovery efficiencies from mushrooms, lettuce, and raspberries were approximately 12%. Recovery efficiencies from bean sprouts were approximately 4%. Although no significant difference in recovery efficiency could be detected between samples processed using the lectin-coated beads and samples processed without this procedure, distinct advantages were apparent when the lectin-coated beads were used. A considerably smaller, cleaner final volume remained for microscopy, which increases the sensitivity of the technique and reduces operator time.

Cyclospora↗
PubMed2001

A report case of Cyclospora and Cryptosporidium mixed infection in a HIV-negative child in Thailand.

The first case of cyclosporosis in a non HIV-infected child in Thailand, co-infected with Cryptosporidium, was reported. The patient was a 3 year-old malnourished orphan who presented with fever, abdominal distension and relapsing diarrhea. There was no leukocyte in her stool, however, numerous Cyclospora and Cryptosporidium oocysts were identified by modified acid-fast staining. The illness was cured by co-trimoxazole and fluid therapy. More coccidial infections in Thailand may be detected if modified acid-fast staining is routinely performed.

Animals↗
PubMed2002

[Prolonged diarrhea and weight loss after a biking trip from Tibet to Nepal: infection with Cyclospora].

A 39-year-old man, who had made a cycling tour from Tibet to Nepal, visited the outpatients' clinic one month later because of prolonged diarrhoea, abdominal complaints and serious weight loss. Parasitological examination of the stool revealed oocysts of Cyclospora cayetanensis and the patient was treated with trimethoprim-sulfamethoxazole (co-trimoxazole) with good result. C. cayetanensis has only recently been discovered as a protozoal cause of diarrhoea. Infections are primarily reported from areas with a low hygienic standard e.g. Central and South America, the Indian subcontinent (Nepal), Indonesia and South-East Asia. Clinical symptoms of infection are diarrhoea (usually watery), abdominal cramps and discomfort. The infection can have a prolonged course. Diagnosis is made by parasitological examination of the stool (one should be cautious not to confuse with cryptosporidia) and treatment with trimethoprim-sulfamethoxazole is effective.

Adult↗
PubMed2002

Cyclospora cayetanensis: oocyst characteristics and excystation.

In Thailand in 1999-2000, Cyclospora oocysts from two HIV-infected patients and one patient with prolonged diarrhea were detected by formalin-ether concentration technique. Sporulation was performed by mixing stool samples in 2.5% potassium dichromate solution, sporulated oocysts were then treated with various solutions before mechanical rupturing in order to establish excystation, fewer than 10% of the sporulated oocysts could be excysted. Our techniques provided more details of the characteristic appearance of sporocysts and sporozoites within the oocysts (DMSO-modified acid-fast technique with our modification).

Animals↗
PubMed2006

Co-infection of Giardia intestinalis and Cyclospora cayetanensis in an immunocompetent patient with prolonged diarrhea: case report.

Cyclospora cayetanensis is an agent of emerging infectious disease, and a recognized cause of diarrhea in some patients. Also, the flagellated protozoan, Giardia intestinalis, induces a diarrheal illness of the small intestine. Cases of cyclosporiasis are frequently missed, primarily due to the fact that the parasite can be quite difficult to detect in human fecal samples, despite an increasing amount of data regarding this parasite. On the other hand, G. intestinalis can be readily recognized via the microscopic visualization of its trophozoite or cyst forms in stained preparations or unstained wet mounts. In this report, we describe an uncommon case of co-infection with G. intestinalis and C. cayetanensis in an immunocompetent patient with prolonged diarrhea, living in a non-tropical region of Turkey.

Adult↗
PubMed2006

[Study on the expression of immune function in cases infected by Cyclospora cayetanensis].

In Cyclospora cayetanensis oocyst-positive patients, T cell subsets in peripheral mononuclear cell and membrane interleukin-2 receptor (mIL-2R) were detected with the method of biotin-streptavidin (BSA) and soluble interleukin-2 receptor (sIL-2R) as well as special IgG, IgM in serum was detected by ELISA. Results showed that there is a significant difference between the infected and uninfected individuals.

Adolescent↗
PubMed1994

Diarrhea associated with Cyclospora Sp. in Bangladesh.

A spherical acid-fast organism measuring approximately 10 microns in diameter (Cyclospora sp.) has recently been implicated in diarrheal diseases in many parts of the world. We detected this organism in the stools of six Bangladeshi patients with diarrhea. Four patients had chronic diarrhea and two had acute diarrhea at the time of presentation. This is the first report of infection with this organism in the indigenous population from this region.

Adult↗
PubMed1998

Fuchsin fluorescence and autofluorescence in Cryptosporidium, Isospora and Cyclospora oocysts.

Cryptosporidium parvum and Isospora belli oocysts stained with carbol-fuchsin, as in a modified Ziehl Neelsen technique, fluoresce bright red under green light (546nm). Cryptosporidium oocysts tend to fluoresce more brightly the less intensely stained they appear under transmitted light; this is not the case with Isospora. Fuchsin-stained Cyclospora cayetanensis oocysts fluoresce rather dimly, but those not taking the dye retain their typical autofluorescence. Cryptosporidium and Isospora oocysts are also autofluorescent, appearing violet under u.v. light (365 nm), and green under violet (405 nm) and blue-violet light (436 nm). Their autofluorescence does not survive the staining procedure.

Animals↗
PubMed2001

[Cyclosporiasis: a clinical and epidemiological study in travellers with imported Cyclospora cayetanensis infection].

BACKGROUND: To assess the clinical and epidemiological characteristics of the enteritis produced by Cyclospora cayetanensis. PATIENTS AND METHOD: A microbiological, epidemiological and clinical protocol in travelers to tropical and temperate areas affected by travelers diarrhea (TD). RESULTS: C. cayetanenesis was isolated from 55 patients. 96% of them suffered TD. Persistent diarrhea (> 2 weeks) was present in 69% and weight loss > or = 3 kg in 38%. In 36% of cases, TD began after returning from the trip. Although C. cayetanensis has a cosmopolitan distribution, it was mostly isolated from travellers to Latin America, the Indian subcontinent and South East Asia. In only five cases a potential risk factor was detected: strawberries (3), buffalo's milk (1) and marinated fish "ceviche" (1). CONCLUSIONS: C. cayetanensis is an emerging enteropathogen, isolated in 2-4% of Spanish travellers suffering from TD, and should be considered in the diferential diagnosis of this clinical entity.

Cyclosporiasis↗
PubMed1996

The incidence of Cyclospora cayetanensis in stool samples submitted to a district general hospital.

Cyclospora cayetanensis is the cause of a prolonged diarrhoeal syndrome. In the UK most cases are seen in travellers who have returned from countries in which the organism is endemic. The purpose of this investigation was to determine the incidence of C. cayetanensis in stool samples submitted to a district general hospital. A total of 6151 stools from 5374 different patients were screened for the presence of C. cayetanensis over a 1-year period using the modified Ziehl-Neelsen technique. Oocysts of C. cayetanensis were found in 7 stools (0.1%) from 4 patients (0.07%). All four patients were adult travellers who had visited countries in which C. cayetanensis is known to be endemic. In the population of this study, C. cayetanensis was found to be a rare cause of diarrhoea. Although C. cayetanensis infection should be considered in individuals of all ages who have lived in, or have travelled to endemic areas, there is no need to screen stool samples for the organism in those without such a travel history.

Adult↗
PubMed1997

An outbreak in 1996 of cyclosporiasis associated with imported raspberries. The Cyclospora Working Group.

BACKGROUND: Cyclospora cayetanensis is a parasite that causes gastroenteritis. Until last year most of the documented cases of cyclosporiasis in North America were in overseas travelers. In 1996, a large outbreak of cyclosporiasis occurred in North America. We investigated this outbreak. METHODS: Health departments solicited information from clinicians and laboratories on cases of cyclosporiasis, which were then reported to the Centers for Disease Control and Prevention and to Health Canada. We conducted retrospective cohort studies for the cases associated with events (e.g., luncheons) and attempted to identify the sources of the implicated food. RESULTS: A total of 1465 cases of cyclosporiasis were reported by 20 states, the District of Columbia, and 2 provinces. Of these cases, 978 (66.8 percent) were laboratory confirmed and 725 (49.5 percent) were associated with 55 events that were held from May 3 through June 14. Raspberries were definitely served at 50 events and may have been served at 4 events. For 27 of the 41 events for which adequate data were available (65.8 percent), the associations between the consumption of berries (raspberries with or without other berries) and cyclosporiasis were statistically significant (P<0.05). For all 29 events for which there were good data, the raspberries definitely came from Guatemala (21 events, 72.4 percent) or may have come from Guatemala (8 events, 27.6 percent). As few as five Guatemalan farms could have accounted for the 25 events for which the raspberries could be traced to a single exporter per event. The mode of contamination of the raspberries remains unclear. CONCLUSIONS: This large outbreak of cyclosporiasis in North America in 1996 was associated with the consumption of Guatemalan raspberries. The outbreak illustrates the need to consider that a local cluster of foodborne illness may be part of a widespread outbreak and to pursue investigations to the source of the implicated vehicle.

Adolescent↗
PubMed1997

Epidemiology and treatment of Cyclospora cayetanensis infection in Peruvian children.

Cyclospora cayetanensis was detected in fecal specimens from 63 (1.1%) of 5,836 Peruvian children studied over 2 years; the protozoan was detected by modified acid-fast staining and autofluorescence under ultraviolet light. The highest prevalence occurred among children between 2 and 4 years of age. Thirty-two percent (20) of the 63 C. cayetanensis-infected children were symptomatic. Nineteen infected children were enrolled in a double-blind, placebo-controlled trial of a 3-day course of trimethoprim-sulfamethoxazole (TMP-SMZ; 5/25 mg/[kg x d]). Children were followed up with daily stool examinations (mean number of samples examined per child +/- SE, 19 +/- 4). The mean duration of oocyst excretion +/- SE was 4.8 +/- 1.2 days for TMP-SMZ recipients compared with 12.1 +/- 6.1 days for placebo recipients (P < .02). The prevalence of C. cayetanensis infection decreases during winter months and as children age; it decreases precipitously by adulthood. In children in areas of endemicity, C. cayetanensis usually causes mild disease that is often asymptomatic. TMP-SMZ therapy significantly decreases the duration of oocyst excretion.

Adolescent↗
PubMed1997

Sporulation of Cyclospora sp. oocysts.

Cyclospora sp. oocysts sporulated maximally at 22 and 30 degrees C for 14 days retarded sporulation. Up to 12% of human- and baboon-derived oocysts previously stored at 4 degrees C for 1 to 2 months sporulated when stored for 6 to 7 days at 30 degrees C.

Animals↗