eMedicine Specialties > Infectious Diseases > Parasitic Infections

Cryptosporidiosis: Follow-up

Author: 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
Contributor Information and Disclosures

Updated: Jun 23, 2008

Follow-up

Inpatient & Outpatient Medications

  • In patients with AIDS, cryptosporidiosis usually cannot be eradicated prior to restoration of the CD4 cell count in response to HAART. During early immune reconstitution, patients should generally continue antiparasitic therapy (such as nitazoxanide or paromomycin) and antimotility agents, as needed.

Deterrence/Prevention

  • Drinking water should be purified by filtration. This can be accomplished using 1-μm water filters when drinking tap water. Patients with AIDS should drink only filtered water.
  • Boil or filter water in countries with a high risk of transmission.
  • Avoid newborn animals (eg, calves, lambs), including domestic animals. New pets for patients with AIDS should be older than 6 months and should not have diarrhea.
  • Health care worker, childcare workers, and health-compromised patients should avoid fecal-oral spread by wearing gloves and washing their hands after contact with human feces. Spread can occur after activities such as changing diapers.

Complications

  • Sclerosing cholangitis, acalculous cholecystis, papillary stenosis, and pancreatitis may develop with biliary involvement.
  • Patients with AIDS may develop respiratory tract infections.
  • Rare cases of pancreatitis have been recorded in immunocompetent patients.

Prognosis

  • Prolonged diarrhea (ie, >1 mo) and biliary disease indicate a poor prognosis in persons with AIDS.

Patient Education

  • Encourage immunocompromised patients to consider using 1-μm water filters when drinking tap water.
  • Instruct patients to boil or filter water in countries with a high risk of transmission.
  • Instruct immunocompromised patients to avoid newborn animals (eg, calves, lambs), including domestic animals, and people with diarrhea. New pets for patients with AIDS should be older than 6 months and should not have diarrhea.
  • Instruct patients with AIDS, daycare workers, and health care workers to avoid fecal-oral spread by wearing gloves and washing their hands after contact with human feces. Spread can occur after activities such as changing diapers.

Miscellaneous

Medicolegal Pitfalls

  • Prolonged diarrhea caused by cryptosporidiosis may warrant HIV testing. Provide appropriate counseling before and after administration of the HIV test.
  • Outbreaks of cryptosporidiosis should be detected by vigilant observation for increased case numbers at primary and public health care levels.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor Damon Eisen, MD, to the development and writing of this article.



More on Cryptosporidiosis

Overview: Cryptosporidiosis
Differential Diagnoses & Workup: Cryptosporidiosis
Treatment & Medication: Cryptosporidiosis
Follow-up: Cryptosporidiosis
Multimedia: Cryptosporidiosis
References
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References

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Further Reading

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Keywords

cryptosporidiosis, biliary cryptosporidiosis, calf scours, slim disease, Cryptosporidium parvum, C parvum, Cryptosporidium hominis, C hominis, cryptosporidia, Apicomplexa protozoan, diarrhea, abdominal cramps, low-grade fever, acalculous cholecystitis, sclerosing cholangitis, papillary stenosis, pancreatitis

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Contributor Information and Disclosures

Author

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
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.

Medical Editor

Jeffrey D Band, MD, Clinical Professor of Medicine, Wayne State University School of Medicine; Director, Division of Infectious Diseases and International Medicine, William Beaumont Hospital Corporation
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Joseph F John Jr, MD, FACP, FIDSA, FSHEA, Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center
Disclosure: BioMerieux Honoraria Review panel membership; Cubist Honoraria Review panel membership; Pfizer Honoraria Speaking and teaching; Merck Stock dividends stock holdings

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
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.

 
 
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