Cyklosporoza
Objawy

Cyklosporoza jest pasożytniczą infekcją jelita cienkiego wywołaną przez Cyclospora cayetanensis, przenoszoną przez spożycie skażonej żywności lub wody. Inkubacja trwa zwykle około 7 dni (2 dni do ponad 2 tygodni). Dominującym objawem jest wodnista biegunka, często o charakterze wybuchowym, z 6-7 wypróżnieniami dziennie, towarzyszą jej bóle brzucha, wzdęcia, nudności, osłabienie, bóle mięśniowe oraz niska gorączka. U pacjentów z obniżoną odpornością (HIV/AIDS, immunosupresja) przebieg jest cięższy, z możliwym występowaniem śluzu i krwi w kale oraz powikłań takich jak bezkamieniowe zapalenie pęcherzyka żółciowego, zespół Guillaina-Barrégo czy zapalenie stawów. W badaniach laboratoryjnych często obserwuje się eozynofilię (48% przypadków) oraz zmiany zapalne w błonie śluzowej jelita cienkiego. Przebieg choroby jest zmienny, z objawami trwającymi 6-7 tygodni u osób immunokompetentnych i do 199 dni u pacjentów HIV-pozytywnych, z charakterystycznymi nawrotami symptomów.

Cyklosporoza – definicja

Cyklosporoza (łac. Cyclosporiasis) jest chorobą pasożytniczą przewodu pokarmowego wywołaną przez jednokomórkowego pasożyta Cyclospora cayetanensis. Pasożyt ten jest tak mały, że można go zobaczyć jedynie pod mikroskopem i infekuje jelito cienkie człowieka. Do zakażenia dochodzi poprzez spożycie żywności lub wody zanieczyszczonej oocystami Cyclospora.123

Objawy cyklosporozy

Objawy cyklosporozy pojawiają się najczęściej po około jednym tygodniu od narażenia na pasożyta (zakres od 2 dni do ponad 2 tygodni). Niektóre osoby zakażone Cyclospora mogą nie wykazywać żadnych objawów klinicznych, a przebieg infekcji może znacznie się różnić w zależności od indywidualnych cech pacjenta.123

Główne objawy kliniczne

Najbardziej typowym objawem cyklosporozy jest wodnista biegunka, która może być obfita i utrzymywać się przez dłuższy czas. U części pacjentów biegunka ma charakter wybuchowy, a liczba wypróżnień może wynosić średnio 6-7 dziennie.123

Do innych częstych objawów cyklosporozy należą:123

  • Utrata apetytu i zmniejszenie masy ciała
  • Bóle brzucha i skurcze jelit
  • Wzdęcia i nadmierna produkcja gazów jelitowych
  • Nudności, niekiedy wymioty
  • Znaczne zmęczenie i osłabienie
  • Bóle mięśniowe
  • Niska gorączka (objawy grypopodobne)

123

U niektórych pacjentów objawy grypopodobne mogą poprzedzać wystąpienie objawów żołądkowo-jelitowych.1

Ciężkość przebiegu choroby

Zakażenie Cyclospora może mieć przebieg łagodny lub bardzo ciężki. Osoby z prawidłowo funkcjonującym układem odpornościowym zwykle doświadczają łagodniejszych objawów, podczas gdy pacjenci z obniżoną odpornością (np. osoby żyjące z HIV/AIDS, chorujące na nowotwory lub przyjmujące leki immunosupresyjne) są narażeni na cięższy przebieg infekcji.12

W cięższych przypadkach, szczególnie u niemowląt, osób starszych oraz osób z upośledzoną odpornością, w kale mogą pojawić się śluz lub krew. U tych pacjentów mogą również wystąpić powikłania takie jak bezkamieniowe zapalenie pęcherzyka żółciowego. Opisywano także przypadki zespołu Guillaina-Barrégo, zapalenia struktur ocznych, reaktywnego zapalenia stawów oraz jałowego zapalenia cewki moczowej jako powikłania cyklosporozy.1

U pacjentów z zaawansowanym zakażeniem HIV, cyklosporoza może powodować ciężką, uporczywą, obfitą biegunkę przypominającą kryptosporidiozę. Choroba pozajelitowa u pacjentów z zaawansowanym HIV może obejmować zapalenie pęcherzyka żółciowego i rozsiane zakażenie.1

Objawy laboratoryjne

W badaniach laboratoryjnych u pacjentów z cyklosporozą obserwowano eozynofilię (48% przypadków). Stan ten nie był wcześniej często opisywany, chociaż w badaniach histopatologicznych obserwowano naciek eozynofilowy i limfocytarny w wycinkach dwunastnicy u pacjentów z cyklosporozą.1

W badaniach biopsyjnych jelita cienkiego wykazano zmiany w błonie śluzowej kosmków jelitowych, rozlany obrzęk i naciek komórkami zapalnymi, reaktywne przekrwienie, rozszerzenie naczyń i przekrwienie włośniczek w obecności pasożyta, co jest zgodne z zapaleniem górnego odcinka przewodu pokarmowego.1

Przebieg choroby

Czas trwania objawów

Przebieg cyklosporozy jest zróżnicowany. U niektórych osób choroba ma charakter samoograniczający się i ustępuje samoistnie. U innych objawy mogą ustąpić, a następnie powrócić. Bez leczenia objawy mogą utrzymywać się przez kilka dni do miesiąca lub dłużej.12

Typowo, dla pacjentów z prawidłową odpornością, objawy trwają 6-7 tygodni bez leczenia. U osób z obniżoną odpornością, objawy mogą utrzymywać się znacznie dłużej – średni czas trwania biegunki u pacjentów HIV-pozytywnych wynosi 199 dni, w porównaniu do 57,2 dni u pacjentów HIV-negatywnych.12

Nawroty choroby

Charakterystyczną cechą cyklosporozy jest to, że objawy mogą ustępować i powracać cyklicznie w czasie trwania infekcji. Pacjent może czuć się lepiej przez kilka dni, a następnie znów poczuć się gorzej, zanim choroba ostatecznie ustąpi.123

Niektóre objawy, takie jak biegunka, mogą ustąpić, a następnie powrócić. Inne objawy, np. zmęczenie, mogą utrzymywać się nawet po ustąpieniu objawów ze strony przewodu pokarmowego.1

Nawet po wyleczeniu zakażenia, osoba która wcześniej przebyła cyklosporozę, może zostać zakażona ponownie, jeśli będzie narażona na kontakt z pasożytem.12

Wydalanie pasożyta

Osoby zakażone mogą wydalać pasożyty Cyclospora przez okres od kilku dni do ponad miesiąca (w czasie aktywnej choroby). Nie jest znany dokładny czas wydalania pasożyta po ustąpieniu objawów.1

Co istotne, ludzie z cyklosporozą wydalają pasożyta w formie nieinfektywnej, która wymaga od kilku dni do kilku tygodni dojrzewania (sporulacji) do formy zakaźnej. Czas potrzebny do dojrzewania do formy zakaźnej zależy od czynników takich jak temperatura i wilgotność.1

Powikłania cyklosporozy

Nieleczona cyklosporoza może prowadzić do poważnych powikłań, zwłaszcza u osób z grup ryzyka. Głównym powikłaniem jest odwodnienie, które może być zagrażające życiu, szczególnie u niemowląt, które są najbardziej narażone na ciężkie odwodnienie i zgon.123

Przedłużająca się biegunka może prowadzić do znacznego odwodnienia i niedożywienia, szczególnie jeśli cyklosporoza jest powikłana współistniejącymi zakażeniami innymi patogenami (wirusowymi, bakteryjnymi lub pasożytniczymi, np. Cryptosporidium i Giardia).1

U pacjentów z obniżoną odpornością mogą występować przewlekłe zapalenie dróg żółciowych oraz inne powikłania, które mogą stanowić zagrożenie dla życia.1

U niektórych pacjentów opisano również rzadkie powikłania neurologiczne, takie jak zespół Guillaina-Barrégo, a także zespół Reitera (reaktywne zapalenie stawów) po przebyciu objawów cyklosporozy.12

Czynniki wpływające na przebieg choroby

Stan układu odpornościowego

Stan układu odpornościowego pacjenta ma kluczowy wpływ na przebieg cyklosporozy. Osoby z prawidłowo funkcjonującym układem odpornościowym zwykle doświadczają łagodniejszych objawów i szybciej wracają do zdrowia, nawet bez leczenia.12

Pacjenci z obniżoną odpornością (np. osoby z HIV/AIDS, pacjenci onkologiczni, osoby po przeszczepach przyjmujące leki immunosupresyjne) są narażeni na cięższy i dłuższy przebieg choroby, z większym ryzykiem powikłań i nawrotów.123

Wiek pacjenta

Obraz kliniczny cyklosporozy w regionach endemicznych różni się w zależności od wieku, przy czym osoby starsze i małe dzieci mają cięższe objawy kliniczne, podczas gdy u starszych dzieci i dorosłych infekcje przebiegają łagodniej.1

Wcześniejsza ekspozycja na pasożyta

Ciężkość i czas trwania infekcji zwykle łagodnieją po powtarzających się epizodach. U osób pochodzących z rejonów, gdzie cyklosporoza występuje endemicznie, często obserwuje się łagodniejsze objawy lub zakażenia bezobjawowe.12

Natomiast podróżni z krajów, gdzie choroba nie występuje endemicznie, prawdopodobnie doświadczą cięższej infekcji przy pierwszym kontakcie z pasożytem.1

Diagnostyka i rozpoznanie

Ze względu na podobieństwo objawów cyklosporozy do innych chorób biegunkowych, lekarze powinni rozważyć zakażenie Cyclospora jako potencjalną przyczynę przedłużającej się biegunki, szczególnie u pacjentów z historią niedawnej podróży do obszarów endemicznych dla Cyclospora.12

Diagnostyka cyklosporozy wymaga badania próbek kału. Rozpoznanie może być trudne, ponieważ nawet pacjenci objawowi mogą nie wydalać wystarczającej ilości pasożyta w kale, aby można go było wykryć w badaniach laboratoryjnych.1

Identyfikacja pasożyta wymaga specjalnych testów, które nie są zwykle wykonywane podczas standardowego badania kału na obecność pasożytów. Dlatego, jeśli istnieją wskazania, pracownicy służby zdrowia powinni specjalnie zlecić badania w kierunku cyklosporozy.1

Lekarze powinni zlecić badania pacjentom, którzy mają objawy zgodne z cyklosporozą, szczególnie jeśli biegunka utrzymuje się dłużej niż kilka dni lub towarzyszy jej znaczna utrata apetytu czy zmęczenie.1

Leczenie i rokowanie

U większości zdrowych osób cyklosporoza może ustąpić samoistnie, jednak leczenie antybiotykami może znacznie skrócić czas trwania objawów.12

Lekiem z wyboru w leczeniu cyklosporozy jest trimetoprim-sulfametoksazol (TMP/SMX) w dawce podwójnej przez 7-10 dni.1

U pacjentów z zaawansowanym HIV mogą być konieczne wyższe dawki i dłuższy czas leczenia, a po zakończeniu leczenia ostrej infekcji stosuje się zwykle długoterminową terapię podtrzymującą (jedna tabletka o podwójnej mocy TMP/SMX 160 mg/800 mg 3 razy w tygodniu), aby zapobiec nawrotom.1

Opieka nad pacjentem z cyklosporozą obejmuje utrzymanie odpowiedniego nawodnienia i zapewnienie możliwie najlepszego odżywienia. Ciężka biegunka może prowadzić do zagrażających życiu powikłań związanych z odwodnieniem.1

Rokowanie w przypadku cyklosporozy jest zazwyczaj dobre, a pełny powrót do zdrowia jest spodziewany, szczególnie u osób z prawidłową odpornością. U osób z obniżoną odpornością choroba może mieć charakter przewlekły i wymagać długotrwałego leczenia.1

Osoby z prawidłowym układem odpornościowym powinny w pełni wyzdrowieć po zakażeniu Cyclospora. Powrót do zdrowia może nastąpić samoistnie lub po zastosowaniu antybiotykoterapii. Objawy mogą utrzymywać się przez tydzień lub dłużej przed poprawą.1

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  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Cyclospora | FDA
    https://www.fda.gov/food/foodborne-pathogens/cyclospora
    Cyclospora cayetanensis is a parasite that is so small it can only be seen under a microscope. When people eat food or drink water thats contaminated with Cyclospora, they can get an intestinal illness called cyclosporiasis. […] The time between becoming infected and becoming sick is usually about one week. Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, with frequent, sometimes explosive, bowel movements. Other common symptoms include loss of appetite, weight loss, stomach cramps/pain, bloating, increased gas, nausea, and fatigue. People may also experience vomiting, body aches, headache, low-grade fever, and other flu-like symptoms. Some people who are infected with Cyclospora do not have any symptoms. If not treated, the illness may last from a few days to a month or longer. Symptoms may seem to go away and then return one or more times (relapse). Its common to feel very tired.
  • #1 Symptoms of Cyclosporiasis | Cyclosporiasis | CDC
    https://www.cdc.gov/cyclosporiasis/signs-symptoms/index.html
    Cyclosporiasis symptoms can vary. […] Symptoms usually begin about one week after becoming infected. […] Watery diarrhea is the most common symptom of cyclosporiasis. […] People experience symptoms of cyclosporiasis about one week (ranging as soon as 2 days 2 weeks or more) after consuming food or drinking water containing Cyclospora. […] Symptoms of cyclosporiasis may include Watery diarrhea (most common), Loss of appetite, Weight loss, Cramping, Bloating, Increased gas, Nausea, Fatigue. […] Without treatment, symptoms can last anywhere from a few days to a month or longer. Some symptoms, such as diarrhea, may go away and then return. Other symptoms, such as fatigue, may continue after the gastrointestinal symptoms have stopped.
  • #1 Cyclosporiasis: Transmission, Symptoms, Treatment & Prevention
    https://my.clevelandclinic.org/health/diseases/17957-cyclosporiasis
    Symptoms of cyclosporiasis usually start within a week of exposure (eating or drinking contaminated food or water) and include: Watery or explosive diarrhea. Loss of appetite. Bloating and gas. Fatigue (extreme tiredness). Low-grade fever. Nausea. Stomach cramps. Vomiting. […] A Cyclospora infection can be mild or very serious. Youre most at risk for a serious infection if you have a compromised (weakened) immune system (for instance, youre living with HIV/AIDS or cancer or youre taking immunosuppressive medications). If you dont treat cyclosporiasis, you can be sick for a long time or have symptoms get better and then come back. […] If you dont treat a Cyclospora infection, your symptoms could last a month or longer. This puts you at risk of severe dehydration and other complications.
  • #1 Cyclospora: symptoms, prevention & treatment – Genetic Signatures USA
    https://geneticsignatures.com/us/our-products/gastrointestinal-infections/cyclospora-symptoms-prevention-treatment-copy/
    Cyclospora infects the small intestine, typically causing a range of gastrointestinal symptoms such as; profuse watery diarrhea, sometimes explosive bowel movements, and abdominal cramping. […] Other symptoms can also include nausea, fatigue, low-grade fever, anorexia, and weight loss. […] In more severe disease mucus or blood can be found in the stool which occurs most commonly in infants, the elderly, and immunocompromised patients such as those living with HIV/AIDS. Symptoms in these hosts can include acalculous cholecystitis. Guillain-Barré syndrome, ocular inflammation, reactive arthritis, and sterile urethritis have also been reported. […] Travelers from non-endemic countries are likely to experience more severe infection. Prolonged diarrhea can result in dehydration and malnutrition and may infrequently result in death, particularly in infants and individuals with other infections or co-morbidities. […] Healthcare providers should consider Cyclospora as a potential cause of prolonged diarrheal illness, particularly in patients with a history of recent travel to Cyclospora-endemic areas.
  • #1 Cyclospora
    https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/diseases/cyclospora.html
    Cyclospora infects the small intestine and typically causes an illness characterized by watery diarrhea, with an average of about six to seven stools per day. Other symptoms can include loss of appetite, weight loss, bloating, increased gas, stomach cramps, nausea, vomiting, tiredness, muscle aches and low-grade fever. Some persons notice flu-like symptoms before they notice the gastrointestinal symptoms. Some persons infected with Cyclospora do not develop any symptoms. […] The length of time between becoming infected and developing symptoms probably averages at least several days and quite commonly is about a week. However, both shorter and longer intervals have been reported. If not treated, the illness may last for a few days to a month or longer and may come back one or more times. It is not known whether persons with compromised immune systems, such as persons who have AIDS, more commonly develop severe illness if infected with Cyclospora.
  • #1 Cyclosporiasis – Infectious Diseases – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/infectious-diseases/intestinal-protozoa-and-microsporidia/cyclosporiasis
    Symptoms include watery diarrhea with gastrointestinal and systemic symptoms. […] The primary symptom of cyclosporiasis is sudden, nonbloody, watery diarrhea, with fever, abdominal cramps, nausea, anorexia, malaise, and weight loss. In immunocompetent patients, the illness usually resolves spontaneously but can last weeks. Relapses may follow improvement in symptoms. […] In hosts with depressed cell-mediated immunity as occurs in patients with end-stage human immunodeficiency virus (HIV), cyclosporiasis may cause severe, intractable, voluminous diarrhea resembling cryptosporidiosis. Extraintestinal disease in patients with end-stage HIV may include cholecystitis and disseminated infection. […] Most healthy people recover without treatment. If not treated, the illness may last for a few days to a month or longer and can relapse.
  • #1
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4155555/
    Cyclospora cayetanensis, a coccidian parasite, can cause gastrointestinal illness in humans and is characterized by watery and persistent diarrhea and abdominal pain. Diarrhea (45.8%), abdominal pain (39.6%), and vomiting (18.8%) were the most frequent symptoms of cases with cyclosporiasis. […] The clinical presentation most frequently associated with cyclosporiasis includes diarrhea, weight loss, abdominal distension, nausea, vomiting, abdominal pain, flatulence, and fever. In the present study, diarrhea was most commonly reported, which is consistent with other studies worldwide. […] Eosinophilia (48%) was observed in 53% of 17 cases of cyclosporiasis in our study. This condition has not been reported previously, although in histopathologic studies, eosinophils and lymphocytic infiltration have been observed in duodenal biopsy specimens of patients with cyclosporiasis. […] In conclusion, Cyclospora was identified in children with symptoms of illness at the Pediatric Hospital of Morelia, Mexico during 2000-2009. Only 45.8% of the children had diarrhea, which suggested prior exposures.
  • #1 Cyclospora cayetanensis and Cyclosporiasis: An Update
    https://www.mdpi.com/2076-2607/7/9/317
    The pathogenesis underlying these symptoms has not been defined. Jejunal biopsies have shown mucosal alterations in intestinal villi, diffuse edema and infiltration by inflammatory cells, reactive hyperemia, vascular dilation and congestion of capillaries in the presence of the parasite, which are compatible with inflammation of the upper intestinal tract.
  • #1 Cyclosporiasis: Transmission, Symptoms, Treatment & Prevention
    https://my.clevelandclinic.org/health/diseases/17957-cyclosporiasis
    The course of cyclosporiasis varies a lot. For some people, its self-limiting, meaning it goes away on its own. In others, symptoms may go away and then come back. If left untreated, symptoms can go on for months. […] Taking care of yourself with cyclosporiasis includes staying hydrated and trying to get whatever nutrition you can. Severe diarrhea can lead to life-threatening complications. […] If you have a healthy immune system, you should make a full recovery from cyclosporiasis. You may get better on your own or with antibiotic treatment. You can have symptoms for a week or longer before getting better.
  • #1 Cyclospora cayetanensis and Cyclosporiasis: An Update
    https://www.mdpi.com/2076-2607/7/9/317
    The main symptoms of C. cayetanensis infection are voluminous watery diarrhea, abdominal cramps, nausea, low grade fever, fatigue and weight loss. […] Although the disease is self-limiting in most of the immunocompetent patients, it may present as a severe, protracted or chronic diarrhea in immunocompromised patients. […] The clinical presentation in endemic settings shows differences by age, with elderly persons and young children having more severe clinical symptoms, while infections are milder in older children and adults. […] The severity and duration of infection tend to become milder after repeated episodes. […] The average duration of diarrhea is longer in HIV-positive patients than in HIV-negative patients (199 days and 57.2 days, respectively). […] Another clinical manifestation of C. cayetanensis infection in HIV-positive patients is biliary disease, acalculous cholecystitis and cholangitis in AIDS patients.
  • #1 Cyclosporiasis – Leeds, Grenville and Lanark District Health Unit
    https://healthunit.org/for-professionals/health-care-dental/communicable-disease-resources/reportable-disease-toolkit/cyclosporiasis/
    Watery diarrhea is the most common symptom and can be profuse and protracted. Anorexia, nausea, vomiting, substantial weight loss, flatulence, abdominal cramping, myalgia, and prolonged fatigue also can occur. […] Infection usually is self-limited, but untreated people may have remitting, relapsing symptoms for weeks to months. Individuals who are not treated may develop chronic complications including Guillain-Barr syndrome or Reiters syndrome. Biliary tract disease also has been reported. […] Immunocompromised individuals appear more susceptible to infection; diarrhea can last for months in some patients. If you have already had cyclosporiasis, you can get it after recovery if you are exposed to the parasite again.
  • #1 Cyclospora | Health & Human Services
    https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/cyclospora
    This parasite infects the small intestine (bowel) and typically causes watery diarrhea, which can be severe. Other symptoms can include nausea, vomiting, abdominal cramping, gas and bloating, fatigue and loss of appetite, anorexia, weight loss, abdominal pain, myalgias, and low-grade fever. […] Untreated, symptoms may last from several days to several weeks (longer in immunocompromised individuals), and weight loss can be significant (exceeding 20 pounds in some cases). […] People may shed Cyclospora parasites for days to over one month (while actively ill). It is not known how long the parasite may be shed after symptoms have stopped.
  • #1 EEIP RIDRM Cyclosporiasis
    https://portal.ct.gov/DPH/Epidemiology-and-Emerging-Infections/EEIP-RIDRM-Cyclosporiasis
    Cyclosporiasis is a diarrheal illness caused by the microscopic parasite Cyclospora cayetanensis. Other symptoms can include loss of appetite, weight loss, stomach cramps and other intestinal symptoms. Common flu-like illness may also be present. […] Humans with cyclosporiasis shed the parasite in a non-infectious form that takes from several days to a couple of weeks to mature (sporulate) into its infectious form. The time required for maturation to the infectious form depends on factors such as temperature and moisture.
  • #1 What is Cyclospora? | Marler BlogLexBlog Logo
    https://www.marlerblog.com/case-news/what-is-cyclospora/
    Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, bloating, increased gas, stomach cramps, and loss of appetite, nausea, low-grade fever, and fatigue. In some cases, vomiting, explosive diarrhea, muscle aches, and substantial weight loss can occur. Some people who are infected with Cyclospora do not have any symptoms. The time between becoming infected and becoming ill is usually about one week. If not treated, the illness may last from a few days up to six weeks. Symptoms also may recur one or more times (relapse). In addition, people who have previously been infected with Cyclospora can become infected again. […] Although human cyclosporiasis is usually not fatal in developed countries such as the United States, protracted diarrhea often leads to dehydration, particularly in infants who are at greatest risk of severe dehydration and death, especially if cyclosporiasis is complicated by infections with other pathogens (viral, bacterial, or parasitic—e.g., Cryptosporidium and Giardia), malnutrition, or malabsorption, particularly in underprivileged communities.
  • #1 Cyclosporiasis – Disease Surveillance Epidemiology Program – MeCDC; DHHS Maine
    https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/disease/cyclosporiasis.shtml
    Cyclosporiasis is an intestinal illness caused by a parasite. People can become infected by consuming food or water contaminated with the parasite. The time between becoming infected and becoming sick is usually about 1 week. Cyclosporiasis infects the small intestine and usually causes diarrhea, loss of appetite, weight loss, and bloating. Other common symptoms include: Stomach cramps, Nausea, Fatigue. Treatment for cyclosporiasis is available. If not treated, the illness may last from a few days to a month or longer. Symptoms may go away and then return one or more times. It is common to feel very tired. […] Cyclosporiasis infection is diagnosed by examining stool specimens. Diagnosis can be difficult because even patients who are symptomatic might not shed enough of the parasite in their stool to be detectable by lab examinations. Identification of the parasite requires special tests that are not usually done when stool is tested for parasites. Therefore, if indicated, healthcare providers should specifically request testing for cyclosporiasis.
  • #1 Cyclospora on Rise in Texas; Testing, Reporting Key to Finding Source – Driscoll Health PlanDriscoll Health Plan on FacebookDriscoll Health Plan on InstagramDriscoll Health Plan on TwitterDriscoll Health Plan on YouTubesearchchevron-rightchevron-upphonesq
    https://driscollhealthplan.com/cyclospora-on-the-rise-in-texas-testing-reporting-key-to-finding-source/
    A spike in illnesses caused by the parasite Cyclospora in June and July is prompting the Texas Department of State Health Services to ask health care providers to be on guard for the illness, pursue testing, and report cases to their local health department. […] Cyclosporiasis is an intestinal illness caused by consuming food or water contaminated with the microscopic Cyclospora parasite. The main symptom is watery diarrhea lasting a few days to a few months. Additional symptoms may include loss of appetite, fatigue, weight loss, abdominal cramps, bloating, increased gas, nausea, vomiting and a low fever. Symptoms may come and go multiple times over a period of weeks or months. […] People with symptoms that could be related to Cyclospora should contact their health care provider for treatment. A health advisory issued today asks providers to test patients who have diarrhea lasting more than a few days or diarrhea accompanied by severe loss of appetite or fatigue. Health care providers should promptly report cases so that public health can investigate them and attempt to determine the source in order to head off future cases.
  • #1 Cyclosporiasis – Infectious Diseases – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/infectious-diseases/intestinal-protozoa-and-microsporidia/cyclosporiasis
    Treatment of choice for cyclosporiasis is double-strength TMP/SMX for 7 to 10 days. […] In patients with end-stage HIV, higher doses and longer duration may be needed, and treatment of acute infection is usually followed by long-term suppressive therapy (one double-strength 160 mg/800 mg TMP/SMX tablet 3 times weekly) to prevent relapse.
  • #1 Cyclospora Infection (Cyclosporiasis) Treatment, Diagnosis, Prevention
    https://www.medicinenet.com/cyclospora_infection_cyclosporiasis/article.htm
    Cyclospora causes watery diarrhea that lasts more than a week, up to four weeks or more. This is called cyclosporiasis. Abdominal cramping or belly pain and fatigue are common. The infected person may have five to 15 bowel movements per day. Also common are heartburn, nausea, increased gas, decreased appetite, and weight loss. Flu-like symptoms with low-grade fever and muscle aches is less common. Symptoms are worse in those with weak immune systems, such as people with acquired immunodeficiency syndrome (AIDS). […] The prognosis of cyclosporiasis is excellent and complete recovery is anticipated. As discussed above, recovery can be hastened by the use of antibiotics in symptomatic people. Patients who are infected with the human immunodeficiency virus (HIV), however, may relapse after treatment is stopped and should be referred to an infectious disease doctor.
  • #2 Cyclospora Infection (Cyclosporiasis) Fact Sheet
    https://www.health.ny.gov/diseases/communicable/cyclosporiasis/fact_sheet.htm
    Watery diarrhea (loose stool/poop) is the most common symptom. It may last a few days to a month or longer. Symptoms may go away and then come back during the course of infection. Other symptoms may include loss of appetite, stomach cramps, weight loss, muscle aches, nausea (a feeling of sickness in the stomach), vomiting, and tiredness. Symptoms appear approximately one week after consuming contaminated food or water. […] Cyclospora is a microscopic (tiny, not seen without a microscope) parasite that can affect the intestinal tract and cause diarrhea (loose stool/poop) in those who get infected.
  • #2 Cyclospora
    https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/diseases/cyclospora.html
    Cyclospora infects the small intestine and typically causes an illness characterized by watery diarrhea, with an average of about six to seven stools per day. Other symptoms can include loss of appetite, weight loss, bloating, increased gas, stomach cramps, nausea, vomiting, tiredness, muscle aches and low-grade fever. Some persons notice flu-like symptoms before they notice the gastrointestinal symptoms. Some persons infected with Cyclospora do not develop any symptoms. […] The length of time between becoming infected and developing symptoms probably averages at least several days and quite commonly is about a week. However, both shorter and longer intervals have been reported. If not treated, the illness may last for a few days to a month or longer and may come back one or more times. It is not known whether persons with compromised immune systems, such as persons who have AIDS, more commonly develop severe illness if infected with Cyclospora.
  • #2 Cyclospora | FDA
    https://www.fda.gov/food/foodborne-pathogens/cyclospora
    Cyclospora cayetanensis is a parasite that is so small it can only be seen under a microscope. When people eat food or drink water thats contaminated with Cyclospora, they can get an intestinal illness called cyclosporiasis. […] The time between becoming infected and becoming sick is usually about one week. Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, with frequent, sometimes explosive, bowel movements. Other common symptoms include loss of appetite, weight loss, stomach cramps/pain, bloating, increased gas, nausea, and fatigue. People may also experience vomiting, body aches, headache, low-grade fever, and other flu-like symptoms. Some people who are infected with Cyclospora do not have any symptoms. If not treated, the illness may last from a few days to a month or longer. Symptoms may seem to go away and then return one or more times (relapse). Its common to feel very tired.
  • #2 About Cyclosporiasis | Cyclosporiasis | CDC
    https://www.cdc.gov/cyclosporiasis/about/index.html
    People who are infected with Cyclospora may or may not experience symptoms. Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea with frequent and sometimes explosive bowel movements. […] If not treated, the illness may last from a few days to over a month. Symptoms may seem to go away and then return one or more times (relapse). […] Most people with healthy immune systems will eventually recover from cyclosporiasis without treatment. However, if not treated, you may be sick for anywhere from a few days to a month or longer. You may also have symptoms that seem to go away, but then return one or more times (relapse). People in poor health or those who are immunocompromised may be at a higher risk for severe or long illness.
  • #2 Cyclosporiasis – Infectious Diseases – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/infectious-diseases/intestinal-protozoa-and-microsporidia/cyclosporiasis
    Symptoms include watery diarrhea with gastrointestinal and systemic symptoms. […] The primary symptom of cyclosporiasis is sudden, nonbloody, watery diarrhea, with fever, abdominal cramps, nausea, anorexia, malaise, and weight loss. In immunocompetent patients, the illness usually resolves spontaneously but can last weeks. Relapses may follow improvement in symptoms. […] In hosts with depressed cell-mediated immunity as occurs in patients with end-stage human immunodeficiency virus (HIV), cyclosporiasis may cause severe, intractable, voluminous diarrhea resembling cryptosporidiosis. Extraintestinal disease in patients with end-stage HIV may include cholecystitis and disseminated infection. […] Most healthy people recover without treatment. If not treated, the illness may last for a few days to a month or longer and can relapse.
  • #2 Cyclosporiasis (Cyclospora Infection) | Disease Outbreak Control Division
    https://health.hawaii.gov/docd/disease_listing/cyclosporiasis-cyclospora-infection/
    The symptoms usually start about 1 week after a person is exposed to the parasite, but can range from 1-20 days. Symptoms last for about 10-24 days but can be longer in persons who are immunocompromised. The most common symptoms are watery diarrhea, loss of appetite, abdominal pain, nausea and sometimes vomiting. […] If not treated, the illness may last for a few days to a month or longer. Symptoms may seem to go away and then return one or more times (relapse). […] People who are in poor health or who have weakened immune systems may be at higher risk for severe or prolonged illness.
  • #2 What is Cyclospora? | Marler BlogLexBlog Logo
    https://www.marlerblog.com/case-news/what-is-cyclospora/
    Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, bloating, increased gas, stomach cramps, and loss of appetite, nausea, low-grade fever, and fatigue. In some cases, vomiting, explosive diarrhea, muscle aches, and substantial weight loss can occur. Some people who are infected with Cyclospora do not have any symptoms. The time between becoming infected and becoming ill is usually about one week. If not treated, the illness may last from a few days up to six weeks. Symptoms also may recur one or more times (relapse). In addition, people who have previously been infected with Cyclospora can become infected again. […] Although human cyclosporiasis is usually not fatal in developed countries such as the United States, protracted diarrhea often leads to dehydration, particularly in infants who are at greatest risk of severe dehydration and death, especially if cyclosporiasis is complicated by infections with other pathogens (viral, bacterial, or parasitic—e.g., Cryptosporidium and Giardia), malnutrition, or malabsorption, particularly in underprivileged communities.
  • #2 Cyclosporiasis: Transmission, Symptoms, Treatment & Prevention
    https://my.clevelandclinic.org/health/diseases/17957-cyclosporiasis
    The course of cyclosporiasis varies a lot. For some people, its self-limiting, meaning it goes away on its own. In others, symptoms may go away and then come back. If left untreated, symptoms can go on for months. […] Taking care of yourself with cyclosporiasis includes staying hydrated and trying to get whatever nutrition you can. Severe diarrhea can lead to life-threatening complications. […] If you have a healthy immune system, you should make a full recovery from cyclosporiasis. You may get better on your own or with antibiotic treatment. You can have symptoms for a week or longer before getting better.
  • #2 Reiter syndrome following protracted symptoms of Cyclospora infection.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC2631790/
    Two large outbreaks of diarrheal illness associated with Cyclospora cayetanensis, a coccidian parasite, provided an opportunity to evaluate clinical syndromes associated with this enteric pathogen. […] We describe the first case of Reiter syndrome following protracted symptoms of Cyclospora infection.
  • #2 Health: Infectious Disease Epidemiology & Prevention Division: Cyclosporiasis
    https://www.in.gov/health/idepd/diseases-and-conditions-resource-page/cyclosporiasis/
    Symptoms include: […] Symptoms normally begin around 7 days after exposure but can range from 2-14 days. […] Symptoms can last for a few days to more than a month if not treated. If left untreated, some people may also experience a cycle of symptoms. In these cases, infected people will feel sick, then feel better for a few days, and then start to feel sick again. […] Some infected people do not have any symptoms, particularly people from areas where cyclosporiasis is routinely expected (endemic) particularly in tropical and subtropical regions.
  • #2 Test Patients With Symptoms Consistent With Cyclospora Infection | Texas DSHS
    https://www.dshs.texas.gov/news-alerts/test-patients-symptoms-consistent-cyclospora-infection
    Symptoms of cyclosporiasis usually begin 2 to 14 days after ingestion of Cyclospora eggs, or oocysts, in contaminated food or water. Watery diarrhea can persist for several weeks to a month or more, and affected patients may experience a return of symptoms after improvement. Additional symptoms may include anorexia (loss of appetite), fatigue, weight loss, abdominal cramps, bloating, increased gas, nausea, vomiting, and low-grade fever. […] Clinicians should order testing for patients who have symptoms consistent with cyclosporiasis.
  • #2 Cyclospora | Georgia Department of Public Health
    https://dph.georgia.gov/epidemiology/acute-disease-epidemiology/foodborne-and-waterborne-diseases/cyclospora
    Symptoms of cyclosporiasis usually begin about 7 days (range 2 to 14 days) after ingestion of the infectious form of the parasite, sporulated oocysts. The most common symptom is watery diarrhea. Other symptoms may include loss of appetite, weight loss, cramping, bloating, increased gas, nausea, and fatigue. Symptoms can last a few weeks, one month, or more. Symptoms sometimes go away then come back again after a few days or a week. […] Most healthy people will not require antibiotics to treat their illness, however, Cyclosporiasis symptoms may persist for weeks to a month or longer without treatment.
  • #3 Everything You Need to Know About Cyclospora | South Shore Health
    https://www.southshorehealth.org/wellness/blog/what-is-cyclospora-massachusetts-cyclospora-warning
    Cyclospora is the shorthand name for Cyclospora cayetanensis, which is a parasite. This parasite can contaminate food or water; if a human then ingests that food or water, it can lead to illness. The illness caused by Cyclospora is called cyclosporiasis. […] Like most of the illnesses caused by the common pathogens mentioned above, cyclosporiasis is a gastrointestinal illness. The most common symptom of cyclosporiasis is diarrhea; other symptoms can include nausea, fatigue, cramping, and flu-like symptoms. […] Dozens of different gastrointestinal illnesses can cause symptoms like diarrhea and nausea, so its important to contact your primary care provider if youre experiencing the symptoms discussed above. Normally, we only suspect something like cyclosporiasis if the symptoms have persisted for 7-10 days. […] While its possible for healthy individuals to fight off a Cyclospora infection without treatment, the normal recommended treatment for cyclosporiasis is a course of Trimethoprim-sulfa (TMP-SMX), which is an antibiotic. Fluids may be given as well to help replenish those lost from diarrhea.
  • #3 Test Patients With Symptoms Consistent With Cyclospora Infection | Texas DSHS
    https://www.dshs.texas.gov/news-alerts/test-patients-symptoms-consistent-cyclospora-infection
    Symptoms of cyclosporiasis usually begin 2 to 14 days after ingestion of Cyclospora eggs, or oocysts, in contaminated food or water. Watery diarrhea can persist for several weeks to a month or more, and affected patients may experience a return of symptoms after improvement. Additional symptoms may include anorexia (loss of appetite), fatigue, weight loss, abdominal cramps, bloating, increased gas, nausea, vomiting, and low-grade fever. […] Clinicians should order testing for patients who have symptoms consistent with cyclosporiasis.
  • #3 Cyclospora
    https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/diseases/cyclospora.html
    Cyclospora infects the small intestine and typically causes an illness characterized by watery diarrhea, with an average of about six to seven stools per day. Other symptoms can include loss of appetite, weight loss, bloating, increased gas, stomach cramps, nausea, vomiting, tiredness, muscle aches and low-grade fever. Some persons notice flu-like symptoms before they notice the gastrointestinal symptoms. Some persons infected with Cyclospora do not develop any symptoms. […] The length of time between becoming infected and developing symptoms probably averages at least several days and quite commonly is about a week. However, both shorter and longer intervals have been reported. If not treated, the illness may last for a few days to a month or longer and may come back one or more times. It is not known whether persons with compromised immune systems, such as persons who have AIDS, more commonly develop severe illness if infected with Cyclospora.
  • #3
    http://www.bccdc.ca/health-info/diseases-conditions/cyclospora-infection
    Cyclospora cayetanensis is a parasite that causes a diarrheal illness. Cyclosporiasis is not usually a serious illness but can persist for several weeks. […] Symptoms start approximately 1 week after exposure to the parasite. A person can be infected and have no symptoms. In some cases, symptoms may continue for more than a month and can sometimes return even after you have started to feel better. […] Cyclosporiasis usually causes: frequent watery, often explosive, diarrhea, abdominal cramps, nausea, vomiting, loss of appetite, weight loss, fatigue, and occasionally fever. […] Untreated, cyclosporiasis will cause prolonged diarrhea, with relapses, especially in people whose immune systems are compromised.
  • #3 Cyclospora | Health & Human Services
    https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/cyclospora
    This parasite infects the small intestine (bowel) and typically causes watery diarrhea, which can be severe. Other symptoms can include nausea, vomiting, abdominal cramping, gas and bloating, fatigue and loss of appetite, anorexia, weight loss, abdominal pain, myalgias, and low-grade fever. […] Untreated, symptoms may last from several days to several weeks (longer in immunocompromised individuals), and weight loss can be significant (exceeding 20 pounds in some cases). […] People may shed Cyclospora parasites for days to over one month (while actively ill). It is not known how long the parasite may be shed after symptoms have stopped.
  • #3 About Cyclosporiasis – MN Dept. of Health
    https://www.health.state.mn.us/diseases/cyclosporasis/basics.html
    Symptoms of cyclosporiasis usually include: […] Symptoms usually begin about 1 week after exposure to the parasite but can begin as short as 2 days or as long as 2 weeks after exposure to the parasite. […] If the infection is not treated, symptoms can last for a few days to months. The symptoms may go in cycles in which you seem to get better for a few days, then feel worse, before the illness ends.
  • #3 What Are the Serious and Long-term Risks of Cyclospora… | Marler Clark
    https://marlerclark.com/foodborne-illnesses/cyclospora/what-are-the-serious-and-long-term-risks-of-cyclospora-infection
    Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, bloating, increased gas, stomach cramps, and loss of appetite, nausea, low-grade fever, and fatigue. […] In untreated, immunocompetent people, the diarrhea can last from days to weeks. […] Although human cyclosporiasis is usually not fatal in developed countries such as the United States, protracted diarrhea often leads to dehydration, particularly in infants who are at greatest risk of severe dehydration and death, especially if cyclosporiasis is complicated by infections with other pathogens (viral, bacterial, or parasitic e.g., Cryptosporidium and Giardia), malnutrition, or malabsorption, particularly in underprivileged communities.
  • #3
    https://www.gov.uk/guidance/cyclospora-clinical-and-travel-guidance
    Symptoms of Cyclospora infection typically begin 7 days after ingestion of sporulated oocysts (the infective form of the parasite). […] Infection with Cyclospora may be asymptomatic or mild in some people particularly in endemic areas. Some people have a flu-like illness for a few days initially, followed by rapid onset of gastrointestinal symptoms. Typical symptoms include: watery diarrhoea, fatigue and muscle pain, loss of appetite, weight loss, cramping, abdominal wind or bloating, nausea. […] Illness caused by Cyclospora is self-limiting in most people, but can be prolonged for 6 weeks or so and particularly severe in those who are immunocompromised, such as those with HIV infection.