Abstract
Previous reports of diarrhea resulting from Cyclospora species have been linked to travelers and immunocompromised patients. We conducted a prospective study of 1,042 formalin-ethyl acetate fecal concentrates collected from patients with diarrhea. Between May and November 1993, we identified three patients for whom studies were positive for nonrefractile spherical organisms measuring 10 microns in diameter and containing a cluster of refractile membrane-bound globules. The cysts exhibited variable acid fastness consistent with Cyclospora species. These three patients had no history of recent travel and presented with relapsing, watery, nonbloody diarrhea that lasted from 12 days to 8 weeks. No other parasitic or bacterial pathogens were identified in their stools. All three instances of diarrhea occurred in May or June. No common source of food or water was identified. None of these patients were immunosuppressed, and their diarrhea resolved spontaneously. We suggest that Cyclospora species should be considered in community-acquired diarrhea.
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Selected References
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- Hale D., Aldeen W., Carroll K. Diarrhea associated with Cyanobacterialike bodies in an immunocompetent host. An unusual epidemiological source. JAMA. 1994 Jan 12;271(2):144–145. [PubMed] [Google Scholar]
- Hart A. S., Ridinger M. T., Soundarajan R., Peters C. S., Swiatlo A. L., Kocka F. E. Novel organism associated with chronic diarrhoea in AIDS. Lancet. 1990 Jan 20;335(8682):169–170. doi: 10.1016/0140-6736(90)90042-4. [DOI] [PubMed] [Google Scholar]
- Hoge C. W., Shlim D. R., Rajah R., Triplett J., Shear M., Rabold J. G., Echeverria P. Epidemiology of diarrhoeal illness associated with coccidian-like organism among travellers and foreign residents in Nepal. Lancet. 1993 May 8;341(8854):1175–1179. doi: 10.1016/0140-6736(93)91002-4. [DOI] [PubMed] [Google Scholar]
- Long E. G., Ebrahimzadeh A., White E. H., Swisher B., Callaway C. S. Alga associated with diarrhea in patients with acquired immunodeficiency syndrome and in travelers. J Clin Microbiol. 1990 Jun;28(6):1101–1104. doi: 10.1128/jcm.28.6.1101-1104.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Long E. G., White E. H., Carmichael W. W., Quinlisk P. M., Raja R., Swisher B. L., Daugharty H., Cohen M. T. Morphologic and staining characteristics of a cyanobacterium-like organism associated with diarrhea. J Infect Dis. 1991 Jul;164(1):199–202. doi: 10.1093/infdis/164.1.199. [DOI] [PubMed] [Google Scholar]
- Madico G., Gilman R. H., Miranda E., Cabrera L., Sterling C. R. Treatment of Cyclospora infections with co-trimoxazole. Lancet. 1993 Jul 10;342(8863):122–123. doi: 10.1016/0140-6736(93)91330-o. [DOI] [PubMed] [Google Scholar]
- Ortega Y. R., Sterling C. R., Gilman R. H., Cama V. A., Díaz F. Cyclospora species--a new protozoan pathogen of humans. N Engl J Med. 1993 May 6;328(18):1308–1312. doi: 10.1056/NEJM199305063281804. [DOI] [PubMed] [Google Scholar]
- Pape J. W., Verdier R. I., Boncy M., Boncy J., Johnson W. D., Jr Cyclospora infection in adults infected with HIV. Clinical manifestations, treatment, and prophylaxis. Ann Intern Med. 1994 Nov 1;121(9):654–657. doi: 10.7326/0003-4819-121-9-199411010-00004. [DOI] [PubMed] [Google Scholar]
- Pollok R. C., Bendall R. P., Moody A., Chiodini P. L., Churchill D. R. Traveller's diarrhoea associated with cyanobacterium-like bodies. Lancet. 1992 Aug 29;340(8818):556–557. doi: 10.1016/0140-6736(92)91759-2. [DOI] [PubMed] [Google Scholar]
- Shlim D. R., Cohen M. T., Eaton M., Rajah R., Long E. G., Ungar B. L. An alga-like organism associated with an outbreak of prolonged diarrhea among foreigners in Nepal. Am J Trop Med Hyg. 1991 Sep;45(3):383–389. doi: 10.4269/ajtmh.1991.45.383. [DOI] [PubMed] [Google Scholar]
- Wurtz R. M., Kocka F. E., Peters C. S., Weldon-Linne C. M., Kuritza A., Yungbluth P. Clinical characteristics of seven cases of diarrhea associated with a novel acid-fast organism in the stool. Clin Infect Dis. 1993 Jan;16(1):136–138. doi: 10.1093/clinids/16.1.136. [DOI] [PubMed] [Google Scholar]