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Cryptosporidiosis

This intestinal infection typically results in acute, self­limited diarrhea. However, in immunocompromised patients, cryptosporidiosis causes chronic, severe, and life-threatening symptoms.

The disease is prevalent in immunocompromised patients, such as malnourished children, patients with hypogammaglobulinemia, and those who receive immunosuppressants for cancer therapy or organ transplantation. It's especially prevalent in patients with acquired immunodeficiency syndrome.

Cryptosporidiosis occurs worldwide. In addition to immunocompromised patients, travelers to foreign countries, medical personnel caring for patients with the disease, and children are at particular risk. It's spread easily in day-care centers and among house­hold contacts and medical providers. Contaminated water, such as in a swimming pool, is a frequent source of infection.

Causes

Cryptosporidiosis is caused by the protozoan Cryptosporidium. These small spherules inhabit the micro­villus border of the intestinal epithelium. There, the protozoa shed infected oocysts into the intestinal lumen, where they pass into stool.

These oocysts are particularly hardy, resisting destruction by routine water chlorination. This increases the risk of infection spreading through contact with contaminated water. The disease can also be transmitted via contaminated food and person-to-person contact.

Signs and symptoms

The major symptoms are abdominal cramps and watery diarrhea. Less commonly, there are nausea, vomiting, fatigue, and low grade fever. These may lead to weight loss and dehydration.

In otherwise healthy people, these symptoms usually last one to two weeks. In persons with weakened immune systems (such as persons who are HIV infected, persons undergoing cancer treatment, or who have had an organ or bone marrow transplant) the illness can be very severe and persist for weeks to months.

Diagnostic tests 

This is based on either finding the characteristic cysts in stool specimens, or on biopsy of an infected organ, such as the intestine.

Treatment

Although no treatment currently exists that can eradicate the infecting organism, paromomycin may be partially effective for some patients with human immunodeficiency virus.

Treatment of cryptosporidiosis consists mainly of supportive measures to control symptoms. Such measures include fluid replacement to prevent dehydration as well as administration of analgesics to relieve pain and anti-diarrheal and antiperistaltic agents to control diarrhea.

Prevention

The best way to prevent cryptosporidiosis is to minimize exposure to cysts from infected humans and animals. Proper hand washing technique, especially in day care centers, is recommended.



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