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Cryptosporidiosis
Other Resources UpToDate PubMed

Cryptosporidiosis

Contributors: Neil Mendoza MD, Nana Aburjania MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Cryptosporidiosis is an intestinal infection caused by ingestion of the infective oocysts of Cryptosporidium species.

Transmission is primary by the fecal-oral route. Cryptosporidiosis is more common in conditions of crowding and poor sanitation, and infection is a major cause of diarrhea in children in developing countries. In developing countries, many adults may asymptomatically excrete oocysts, and oocysts can frequently be found on vegetables and can contaminate the water supply. In the United States, outbreaks have been associated with contaminated drinking water, contaminated recreational water (including lakes and public pools), and contaminated food.

The incubation period is usually 7-10 days (range 1-30 days).

Clinically, symptoms for cryptosporidiosis can vary widely. In immunocompetent hosts, diarrhea is usually self-limited (lasting 1-2 weeks). The diarrhea may be mild, or it may be voluminous and watery.

In immunocompromised hosts, including patients with AIDS, infection can cause devastating illness. The diarrhea can be severe and prolonged (lasting months), leading to dehydration. In this case, the illness could be life threatening, and some patients may require parenteral nutrition.

Elderly patients typically have more severe disease.

In addition to watery diarrhea, patients may also complain of nausea, vomiting, fever, and abdominal cramping. In immunocompromised patients, infection can also involve the biliary or respiratory tract.

Codes

ICD10CM:
A07.2 – Cryptosporidiosis

SNOMEDCT:
240370009 – Cryptosporidiosis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Other causes of infectious diarrhea:
  • Clostridioides difficile colitis – C difficile enzyme immunoassay (EIA) or polymerase chain reaction (PCR) could be obtained.
  • Bacterial diarrhea – Culture for Salmonellosis, Shigellosis, Campylobacter infections, Enterohemorrhagic Escherichia coli infection. EIA for Shiga toxin.
  • Giardiasis – Giardia EIA should be obtained.
  • Cyclosporiasis and Isospora species – Stool should be sent for special stains.
Noninfectious diarrhea:
  • Inflammatory bowel disease (Crohn disease, Ulcerative colitis)
  • Celiac disease
  • Drug-induced diarrhea
In immunocompromised patients:
  • Microsporidiosis – Stain for microsporidia should be obtained.
  • Mycobacterial species including the Mycobacterium avium-intracellulare infection – Acid fast stain and culture for mycobacteria should be obtained.
  • Cytomegalovirus infection and other viruses – Can cause colitis, diagnosis is usually made by biopsy.

Best Tests

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Therapy

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References

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Last Updated:11/01/2022
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Patient Information for Cryptosporidiosis
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Cryptosporidiosis
A medical illustration showing key findings of Cryptosporidiosis (Mild) : Diarrhea, Fever, Nausea, Malaise, Anorexia, Cramping abdominal pain
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