Retrospective study of the occurrence of Cyclospora cayetanensis at Clinical Hospital of the University of Sao Paulo Medical School, SP.
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Cyclospora cayetanensis causes watery diarrhea in tropical countries, among travelers and after ingestion of contaminated water and food. Very little is known about its epidemiology, pathogenic aspects and reservoirs. In Brazil, its prevalence is unknown and to date there have been reports of three outbreaks. We report here a retrospective study of 5,015 stool samples from 4,869 patients attended at Clinical Hospital of the University of Sao Paulo Medical School, SP, Brazil between April 1996 and January 2002, with 14 cases of Cyclospora cayetanensis being detected there was a prevalence of 0.3%. Of the 14 infected patients, the mean age was 38 years and 71.4% were female. Ten patients presented symptoms; six presented levels of immunological markers and five patients were immunodeficient. (+info)
Cyclosporiasis outbreak, Indonesia.
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We describe an outbreak of Cyclospora cayetanensis infection among Dutch participants at a scientific meeting in September 2001 in Bogor, Indonesia. Fifty percent of the investigated participants were positive for C. cayetanensis. To our knowledge, this outbreak is the first caused by C. cayetanensis among susceptible persons in a disease-endemic area. (+info)
Cyclospora infection in five immunocompetent patients in a Turkish university hospital.
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Infection with Cyclospora has been increasingly reported worldwide in both immunocompetent and immunocompromised individuals. Here the cases of five patients infected with Cyclospora cayetanensis, who sought medical care at Hacettepe University in Turkey, are reported. Diarrhoea occurred from five to fifteen times a day in all of these patients, whose ages ranged from 27 to 67 years. All the patients were considered immunocompetent. Identification of C. cayetanensis was made by detection of the oocysts by using a modified acid-fast stain. (+info)
Cyclosporiasis in an infant.
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This report describes cyclosporiasis in a seven month old infant who presented with incessant crying and refusal of feeds. The routine modified ZN stained smears showed the oocysts of Cyclospora when all other tests failed to reveal enteric pathogens. The need for the clinical laboratory to screen faeces samples for all possible pathogens in a given clinical situation needs to be emphasized. (+info)
Co-infection of Giardia intestinalis and Cyclospora cayetanensis in an immunocompetent patient with prolonged diarrhea: case report.
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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. (+info)
Cyclosporiasis: an emerging public health concern around the world and in Africa.
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BACKGROUND: Cyclosporiasis is an emerging gastro-enteric disease caused by the coccidia protozoan Cyclospora cayetanensis. It is associated with diarrhoea among children in developing countries, in the Americas where C. cayetanensis is endemic, traveller's diarrhoea and/or food and waterborne outbreaks in the developed countries. OBJECTIVES: The aim of this review is to highlight cyclosporiasis and its relevance to public health in East Africa and Africa at large. METHODS: All literature on Cyclospora, C. cayetanensis, cyclosporiasis in Africa, and endemic cyclosporiasis was searched from libraries, colleagues and internet but only literature on its history, clinical presentation, epidemiology in endemic settings, and occurrence in Africa were scrutinised. RESULTS: In Sub Saharan Africa, cyclosporiasis has been reported in at least 3 countries, including Tanzania, in East Africa, occurring in both immunocompromised and immunocompetent patients. Zoonotic species of Cyclospora have also been identified in East African primates, indicating likely endemicity of this little reported disease in the region. This can be attributed to lack of awareness in the public and medical profession concerning the disease, and therefore not routinely checked at the health centres. Cyclosporiasis is characterized by intermittent diarrhoea, and secondary conditions or sequelae such as reactive arthritis syndrome (Reiter's syndrome), have been associated with progression of the disease. Its management is based on antibiotics, an unusual scenario for a protozoa. CONCLUSIONS: Although many aspects of this disease and its transmission remain an enigma, the situation has been rapidly changing since the disease first came to medical attention in the 1970s. (+info)
Faecal and protozoan parasite contamination of water spinach (Ipomoea aquatica) cultivated in urban wastewater in Phnom Penh, Cambodia.
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OBJECTIVE: To identify the level of contamination with thermotolerant coliforms (ThC), intestinal helminth eggs and protozoan parasites in water spinach (Ipomoea aquatica) cultivated in a wastewater-fed lake in Phnom Penh, Cambodia. METHODS: The investigation was carried out from July 2004 to May 2005 in Boeng Cheung Ek lake, a main recipient of wastewater from the city of Phnom Penh. Water spinach samples were collected near two wastewater entry points in the northern part of the lake and near a wastewater exit point in the southern part of the lake, where water is discharged from the lake into a stream. Water spinach samples were harvested at each of the three locations with and without wastewater contact according to the normal practices of farmers, and analysed for ThC, protozoan parasites (Giardia, Cryptosporidium and Cyclospora), and helminth eggs (Ascaris lumbricoides, Trichuris trichura and hookworm) using standard methods. Wastewater samples were also collected at each of the three locations and analysed for ThC and helminth eggs. RESULTS: High concentrations of ThC (approximately 10(5)-10(7)/g) were found in water spinach samples. ThC mean counts did not differ significantly, neither between sample types at each location, nor between locations. ThC mean concentration of water spinach samples collected in the rainy season of 2005 was higher than that in the dry season of 2004. Protozoan parasites were detected in the samples from all three locations and in water spinach harvested with and without wastewater contact. Giardia spp. were present in 56% (20) of samples with an average cyst concentration of 6.6/g. Mean counts of Giardia were not significantly associated with wastewater contact status of water spinach. Cryptosporidium oocysts were found in 17% (six) of samples with an average concentration of 0.5 oocyst per gram of water spinach. Cyclospora oocysts were detected in 8% (three) of samples. Four (11%) water spinach samples contained helminth eggs (average concentration: 0.1 egg per gram). Water samples contained approximately 10(4)-10(7) ThC per 100 ml and a mean of 27.4 helminth eggs per litre. There was a 2-3 log reduction of ThC between the water samples collected at the wastewater entry and exit point(s) of the lake. CONCLUSIONS: Water spinach cultivated in the lake was highly contaminated with feces, as indicated by high ThC concentrations and the presence of protozoan parasites. A reduction in ThC numbers almost to WHO guideline levels for irrigation water occurred through natural biological and physical processes in the lake, as shown by differences in ThC counts at wastewater entry and exit points. (+info)
Chronic diarrhoea in HIV patients: prevalence of coccidian parasites.
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The purpose of this study was to determine the prevalence of intestinal parasites in HIV patients with or without diarrhoea and to see an association between diarrhoea and the coccidian parasites in our setting. Stool samples from 113 HIV patients, 34 chronic diarrhoea and 79 without any history of diarrhoea were collected and examined for enteric parasites by microscopy. One hundred and thirteen control samples from HIV negative patients complaining of prolonged diarrhoea were also collected and analysed. Prevalence of coccidian parasites in HIV and non-HIV patients; with and without diarrhoea was compared using chi-square tests. Enteric parasites were detected in 55.8% HIV patients with diarrhoea compared to 16.4% in patients without diarrhoea (P<0.001). Isospora belli was found in 41.1% (14/34) of chronic diarrhoea and 6.3% (5/79) in non-diarrhoeal cases (P<0.001). Cryptosporidium was detected in 20.6% (7/34) of chronic diarrhoea and 2.5% (2/79) in non-diarrhoeal cases (P<0.001). Cyclospora cayetanensis associated diarrhoea was detected in only one case of chronic diarrhoea (2.9%). CD4+ T-cell count was lower (180 cells/microL) in diarrhoeal HIV patients as compared to non-diarrhoeal patients. Coccidian parasites were seen at a mean CD4+ T-cell count of 186.3 cells/microL. This study concluded that Isospora belli was the predominant parasite followed by Cryptosporidium spp. and both were strongly associated with diarrhoea among HIV patients. (+info)