Résumé
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.
Sujets)
Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Cyclospora/isolement et purification , Cyclosporose/parasitologie , Diarrhée/parasitologie , Voyage , Anti-infectieux/usage thérapeutique , Cyclosporose/diagnostic , Cyclosporose/traitement médicamenteux , Fèces/parasitologie , Association triméthoprime-sulfaméthoxazole/usage thérapeutiqueRésumé
Cylospora cayetanensis, an emerging parasitic pathogen of human is being increasingly recognized throughout the world, however the means of transmission and the possibility of a reservoir host remain an enigma. A longitudinal study on cyclosporiasis in different parts of Nepal was carried out from April, 1995 until November, 2000. Fecal specimens were collected from symptomatic and asymptomatic patients. The data shows a distinct seasonality with the highest infection rates occurring during the summer and rainy season of the year. Attempts have been made to determine the sources of infection and possible reservoir hosts. Stools were examined from nearly 700 animals such as chickens, pigs, buffalos, cows, dogs, cats, monkeys, rats, mice and pigeons. In addition, vegetable farms around the Kathmandu Valley were examined during the seasonal high and low periods of transmission. C. cayetanensis-like oocysts were found in sewage water and from vegetable washings on five occasions during June, July, August, October, and November. Similarly, C. cayetanensis-like oocysts were recovered from mice, rats, chickens, and dogs. These results suggest that these sources may be important in the transmission of this parasitosis. However, further studies will be required to obtain definitive answers on transmission.
Sujets)
Adolescent , Adulte , Répartition par âge , Sujet âgé , Animaux , Animaux domestiques , Animaux sauvages , Enfant , Enfant d'âge préscolaire , Maladies transmissibles émergentes/traitement médicamenteux , Cyclospora/croissance et développement , Cyclosporose/traitement médicamenteux , Réservoirs de maladies , Fèces/parasitologie , Femelle , Parasitologie alimentaire , Humains , Nourrisson , Études longitudinales , Mâle , Adulte d'âge moyen , Népal/épidémiologie , Prévalence , Saisons , Eaux d'égout/parasitologie , Zoonoses/épidémiologieRésumé
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.