Subject(s)
Humans , Male , Female , Adult , Aged , Cyclospora/isolation & purification , Cyclosporiasis/therapy , Cyclosporiasis/diagnosis , Cyclosporiasis/parasitologyABSTRACT
Human infection by Cyclospora cayetanensis, namely cyclosporiasis, can cause a wide range of symptoms in immunocompetent patients, from mild to severe diarrhea. Immunocompromised patients can present with chronic diarrhea and it has been recognized as a cause of traveler's diarrhea. We report three patients who traveled from Chile to Peru, who presented upon returning with prolonged traveler's diarrhea. A literature review about cyclosporiasis is presented, with emphasis on the clinical, epidemiological, diagnostic and therapeutic aspects of this disease.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Cyclospora/isolation & purification , Cyclosporiasis/parasitology , Diarrhea/parasitology , Travel , Anti-Infective Agents/therapeutic use , Cyclosporiasis/diagnosis , Cyclosporiasis/drug therapy , Feces/parasitology , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic useABSTRACT
Cyclospora organisms named C. cercopitheci, C. colobi and C. papionis were identified in stool samples from several primates. They were morphologically indistinguishable from C. cayetanensis but genetically different. In the present work, Cyclospora infection was diagnosed among 140 diarrheic children with three conventional diagnostic methods and was confirmed using nested PCR. The possibility of infection with not only C. cayetanensis but the three Cyclospora species of primates was identified by multiplex PCR among all cyclosporiasis patients diagnosed by different methods. The results showed that Cyclospora was detected in 25 [17.8%], 31 [22.2%], 32 [22.9%] and 35 [25%] patients using modified Kinyoun stain, auto-fluorescent characteristics, sporulation process of the oocysts and nested PCR respectively. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Kappa test were calculated in relation to nested PCR. The single nucleotide polymorphisms [SNPs] in the 18S rRNA gene of C. cayetanensis were identified in 35 cyclosporiasis patients and only one patient had the possibility of human co-infection with primates Cyclospora species [C. cercopitheci, C. colobi and C. papionis] and C. cayetanensis by appearance of a 361-bp. Scanning electron microscopy proved no morphological differences could be detected among Cyclospora oocysts isolated from this patient
Subject(s)
Humans , Male , Female , Cyclosporiasis/parasitology , Feces/parasitology , Child , Polymerase Chain Reaction , CyclosporaABSTRACT
The emergence of a new pathogen Cyclospora cayetanensis as a cause of clinical disease in immunosuppressed hosts is related with prolonged, severe and highly recurrent diarrheas. This paper reports two Cuban cases of cyclosporiasis associated with infection from human immunodeficiency virus in which non sporulated oocysts of Cyclospora cayetanensis were detected in feces by modified Zielhl Neelsen's technique. The most significant clinical symptoms were chronic diarrheas and loss of body weight, with CD4 levels below 200 cells per mm3. The occurrence of severe digestive symptoms in patients with Cyclospora cayetanensi and important immune compromise backed up the concept that this pathogen may act as a new opportunistic pathogen in patients with HIV.