Cryptosporidiosis Clinical Presentation

  • Author: Miguel M Cabada, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Jun 3, 2011
 

History

After an incubation period of 5-10 days (range 2-28 d), an infected individual develops watery diarrhea, which may be associated with abdominal cramps and a low-grade fever. Parasitologically diagnosed cases typically last for about 5-10 days and may persist for 2-4 weeks.

Individuals with AIDS and very low CD4 cell counts may develop a profuse, choleralike diarrhea, which can be complicated by volume depletion and malabsorption.[10] Biliary tract involvement is seen in persons with AIDS who have very low CD4 cell counts and is common in children with X-linked immunodeficiency with hyper–immunoglobulin M (IgM). Biliary involvement may include acalculous cholecystitis, sclerosing cholangitis, papillary stenosis, or pancreatitis. All are associated with right upper quadrant pain, nausea, and vomiting.

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Physical Examination

Physical findings are nonspecific. Temperature higher than 39°C is not characteristic of cryptosporidiosis and warrants investigation for other infections. Patient may have signs of volume depletion or wasting from malabsorption.

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Contributor Information and Disclosures
Author

Miguel M Cabada, MD  Fellow in Infectious Diseases, University of Texas Medical Branch School of Medicine

Miguel M Cabada, MD is a member of the following medical societies: Infectious Diseases Society of America, International Society for Infectious Diseases, and International Society of Travel Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

A Clinton White Jr, MD  The Paul R Stalnaker, MD, Distinguished Professor of Internal Medicine, Director, Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch School of Medicine

A Clinton White Jr, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Federation for Medical Research, American Society of Tropical Medicine and Hygiene, Christian Medical & Dental Society, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Jeffrey D Band, MD  Professor of Medicine, Oakland University William Beaumont School of Medicine; Director, Division of Infectious Diseases and International Medicine, Corporate Epidemiologist, William Beaumont Hospital; Clinical Professor of Medicine, Wayne State University School of Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Joseph F John Jr, MD, FACP, FIDSA, FSHEA  Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina College of Medicine; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Damon Eisen, MD, to the development and writing of the source article.

References

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  2. Lima AAM, Samie A, Guerrant RL. Cryptosporidiosis. In: Guerrant RL, Walker DH, Weller PF, eds. Tropical Infectious Diseases. Philadelphia, Pa: Elsevier-Churchill Livingstone; 2011:640-63.

  3. Yoder JS, Beach MJ. Cryptosporidium surveillance and risk factors in the United States. Exp Parasitol. Jan 2010;124(1):31-9. [Medline].

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  6. Nair P, Mohamed JA, DuPont HL, et al. Epidemiology of cryptosporidiosis in North American travelers to Mexico. Am J Trop Med Hyg. Aug 2008;79(2):210-4. [Medline]. [Full Text].

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  8. Mondal D, Haque R, Sack RB, Kirkpatrick BD, Petri WA Jr. Attribution of malnutrition to cause-specific diarrheal illness: evidence from a prospective study of preschool children in Mirpur, Dhaka, Bangladesh. Am J Trop Med Hyg. May 2009;80(5):824-6. [Medline].

  9. Opintan JA, Newman MJ, Ayeh-Kumi PF, et al. Pediatric diarrhea in southern Ghana: etiology and association with intestinal inflammation and malnutrition. Am J Trop Med Hyg. Oct 2010;83(4):936-43. [Medline]. [Full Text].

  10. O'connor RM, Shaffie R, Kang G, Ward HD. Cryptosporidiosis in patients with HIV/AIDS. AIDS. Mar 13 2011;25(5):549-60. [Medline].

  11. Kaushik K, Khurana S, Wanchu A, Malla N. Evaluation of staining techniques, antigen detection and nested PCR for the diagnosis of cryptosporidiosis in HIV seropositive and seronegative patients. Acta Trop. Jul 2008;107(1):1-7. [Medline].

  12. Amadi B, Mwiya M, Musuku J, et al. Effect of nitazoxanide on morbidity and mortality in Zambian children with cryptosporidiosis: a randomised controlled trial. Lancet. Nov 2 2002;360(9343):1375-80. [Medline].

  13. Rossignol JF, Kabil SM, el-Gohary Y, Younis AM. Effect of nitazoxanide in diarrhea and enteritis caused by Cryptosporidium species. Clin Gastroenterol Hepatol. Mar 2006;4(3):320-4. [Medline].

  14. Rossignol JF, Ayoub A, Ayers MS. Treatment of diarrhea caused by Cryptosporidium parvum: a prospective randomized, double-blind, placebo-controlled study of Nitazoxanide. J Infect Dis. Jul 1 2001;184(1):103-6. [Medline].

  15. Kotler DP, Fogleman L, Tierney AR. Comparison of total parenteral nutrition and an oral, semielemental diet on body composition, physical function, and nutrition-related costs in patients with malabsorption due to acquired immunodeficiency syndrome. JPEN J Parenter Enteral Nutr. May-Jun 1998;22(3):120-6. [Medline].

  16. Lee MB, Greig JD. A review of gastrointestinal outbreaks in schools: effective infection control interventions. J Sch Health. Dec 2010;80(12):588-98. [Medline].

  17. Cabada MM, White AC Jr. Treatment of cryptosporidiosis: do we know what we think we know?. Curr Opin Infect Dis. Oct 2010;23(5):494-9. [Medline].

  18. Pantenburg B, White AC Jr. Nitazoxanide. In: Grayson ML, ed. Kucer's The Use of Antibiotics. 6th ed. London, United Kingdom: Hodder Arnold; 2010:2132-9.

 
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