Custodio H. Protozoan Parasites. Pediatr Rev. 2016 Feb;37(2):59-69; quiz 70-1.
“The incubation period for cryptosporidiosis is 1 to 4 weeks, with an average of 7 days. Although asymptomatic infections occur, affected patients generally experience voluminous, nonbloody, and watery diarrhea. The clinical presentation may vary, depending on the infecting species. C hominis is associated with malaise, vomiting and nausea, and increased oocyst shedding and duration; C parvum is associated with diarrhea only. (13)
For most immunocompetent patients, cryptosporidiosis is self-limited and symptoms usually last 1 to 2 weeks. However, malnourished children or those with T-cell immunodeficiency may have a severe and protracted course that lasts for weeks to months, resulting in dehydration and death.”
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Nacca NE, et al. Nausea, vomiting, and diarrhea in a 9-year-old girl. Pediatr Emerg Care. 2011 Oct;27(10):954-6.
Cryptosporidiosis is reported in an otherwise healthy child. Her history was significant for playing in natural waters during a camping trip 1 week prior. Several days later, she began improving despite an incorrect diagnosis and inappropriate antibiotic therapy. Nitazoxanide was given once the diagnosis was established. Obtaining a thorough patient history, administering appropriate antibiotics, and counseling patients on preventive measures are critical steps in treating and managing the transmission of this parasite. The case emphasizes the value of stool ova and parasite examination for proper diagnosis of pediatric diarrheal illness in the emergency setting. In addition, the often overlooked diagnosis of cryptosporidiosis is reviewed as an important cause of diarrheal illness in the immunocompetent pediatric population.
Chalmers RM, Davies AP. Minireview: clinical cryptosporidiosis. Exp Parasitol. 2010 Jan;124(1):138-46.
Cryptosporidium has emerged as an important cause of diarrhoeal illness worldwide, especially amongst young children and patients with immune deficiencies. Usually presenting as a gastro-enteritis-like syndrome, disease ranges in seriousness from mild to severe and signs and symptoms depend on the site of infection, nutritional and immune status of the host, and parasite-related factors. Sources and routes of transmission are multiple, involving both zoonotic and anthroponotic spread, and facilitated by the resistance of the parasite to many commonly used disinfectants. Prevention and control measures are important for the protection of vulnerable groups since treatment options are limited. This review covers the life cycle, pathogenesis, clinical presentations, diagnosis, prevention and management of cryptosporidiosis in humans.
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Huang DB, et al. Cryptosporidiosis in children. Semin Pediatr Infect Dis. 2004 Oct; 15(4):253-9.
Cryptosporidiosis is an important enteric parasitic infection that is associated with significant morbidity and mortality, especially among individuals who are immunosuppressed and infants and children in the developing world. The seroprevalence of this pathogen is high worldwide, suggesting that exposure occurs commonly. The routes of Cryptosporidium spp. transmission are waterborne, food-borne, and occasionally person-to-person. Infected patients can be asymptomatic or develop watery diarrhea and associated enteric symptoms, which are self-limited in immunocompetent persons. In contrast, immunodeficient individuals develop severe, chronic diarrhea that rarely can lead to extra intestinal cryptosporidiosis. Although the diagnosis of Cryptosporidium infection can be established by examining a modified acid-fast stain of stool for the presence of oocysts, enzyme-linked immunoassays are now the diagnostic modalities of choice. Recent clinical trials in pediatric cryptosporidiosis have shown nitazoxanide to be effective therapy.
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