Cyclospora cayetanensis On the Web
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Cyclospora cayetanensis is a protozoan that causes disease in humans, and possibly in other primates. It has also been isolated from the feces of other animals such as ducks and chickens. Due to the spherical shape of C. cayetanensis sporocytes, it was placed in the Cyclospora genus. It has a double layered wall that gives it resistance against disinfectants and adhesins which are responsible for its adherence characteristics. The bacteria show tropism for epithelial cells of the small intestine, especially of the duodenum and jejunum.
Cyclospora cayetanensis is an obligate intracellular apicomplexan, cyst-forming coccidian protozoan, of the family of Eimeriidae, which commonly causes self-limiting diarrhea. Morphologically C. cayetanensis has spherical oocysts that are between 7.5 and 10 micrometers in diameter that also have a 50 nanometer thick bilayered wall with an outer threadlike coat that has been called a wrinkle by some researchers.
According to a phylogenetic analysis performed with the 18S rRNA gene, in the Cyclospora species isolated from a group of baboons, this species, although different, was proved to be similar to the C. cayetanensis that infects humans. These two species were then documented was belonging to the same clade of the Eimeria species. Other three species of Cyclospora were also identified in non-human primates and characterized with the SSU rRNA analysis, later that year. Because there are morphologically similar, there can not be differentiated by light microscopy. These species: C. cercopitheci, C. colobi and C. papionis were identified in green monkeys, colobus monkeys, and baboons, respectively. C. cayetanensis and these three other species of Cyclospora all share the characteristic of being host-specific.
It is not known the exact conditions and location required for the sporulation of oocysts in the natural environment, however, these data would help to understand and predict the distribution and seasonality of C. cayetanensis. Due to its double-layered wall it is highly resistant, particularly to disinfectants used during food processing. This resistance along with its binding affinity to certain produce, explains the risks associated with contaminated foods. The adhesive properties of C. cayetanensis are stronger than those of the oocysts of Giardia or Cryptosporidium, however, the responsible adhesins are yet to be identified.
C. cayetanensis is an host specific parasite that is able to infect humans. Cyclospora oocysts have also been isolated from the feces of several animals, such as ducks, chickens and dogs. Attempts to identify and to infect different animals with C. cayetanensis have failed. Certain shellfish may acquire C. cayetanensis from contaminated waters, and concentrate its oocyst for several days.
Cyclospora cayetanensis infection must be differentiated from other causes of viral, bacterial, and parasitic gastroentritis.
|Organism||Age predilection||Travel History||Incubation Size (cell)||Incubation Time||History and Symptoms||Diarrhea type8||Food source||Specific consideration|
|Fever||N/V||Cramping Abd Pain||Small Bowel||Large Bowel||Inflammatory||Non-inflammatory|
|Viral||Rotavirus||<2 y||-||<102||<48 h||+||+||-||+||+||-||Mostly in day cares, most common in winter.|
|Norovirus||Any age||-||10 -103||24-48 h||+||+||+||+||+||-||Most common cause of gastroenteritis, abdominal tenderness,|
|Adenovirus||<2 y||-||105 -106||8-10 d||+||+||+||+||+||-||No seasonality|
|Astrovirus||<5 y||-||72-96 h||+||+||+||+||+||Seafood||Mostly during winter|
|Bacterial||Escherichia coli||ETEC||Any age||+||108 -1010||24 h||-||+||+||+||+||-||Causes travelers diarrhea, contains heat-labile toxins (LT) and heat-stable toxins (ST)|
|EPEC||<1 y||-||10†||6-12 h||-||+||+||+||+||Raw beef and chicken||-|
|EIEC||Any ages||-||10†||24 h||+||+||+||+||+||Hamburger meat and unpasteurized milk||Similar to shigellosis, can cause bloody diarrhea|
|EHEC||Any ages||-||10||3-4 d||-||+||+||+||+||Undercooked or raw hamburger (ground beef)||Known as E. coli O157:H7, can cause HUS/TTP.|
|EAEC||Any ages||+||1010||8-18 h||-||-||+||+||+||-||May cause prolonged or persistent diarrhea in children|
|Salmonella sp.||Any ages||+||1||6 to 72 h||+||+||+||+||+||Meats, poultry, eggs, milk and dairy products, fish, shrimp, spices, yeast, coconut, sauces, freshly prepared salad.||Can cause salmonellosis or typhoid fever.|
|Shigella sp.||Any ages||-||10 - 200||8-48 h||+||+||+||+||+||Raw foods, for example, lettuce, salads (potato, tuna, shrimp, macaroni, and chicken)||Some strains produce enterotoxin and Shiga toxin similar to those produced by E. coli O157:H7|
|Campylobacter sp.||<5 y, 15-29 y||-||104||2-5 d||+||+||+||+||+||Undercooked poultry products, unpasteurized milk and cheeses made from unpasteurized milk, vegetables, seafood and contaminated water.||May cause bacteremia, Guillain-Barré syndrome (GBS), hemolytic uremic syndrome (HUS) and recurrent colitis|
|Yersinia enterocolitica||<10 y||-||104 -106||1-11 d||+||+||+||+||+||Meats (pork, beef, lamb, etc.), oysters, fish, crabs, and raw milk.||May cause reactive arthritis; glomerulonephritis; endocarditis; erythema nodosum.|
|Clostridium perfringens||Any ages||> 106||16 h||-||-||+||+||+||Meats (especially beef and poultry), meat-containing products (e.g., gravies and stews), and Mexican foods.||Can survive high heat,|
|Vibrio cholerae||Any ages||-||106-1010||24-48 h||-||+||+||+||+||Seafoods, including molluscan shellfish (oysters, mussels, and clams), crab, lobster, shrimp, squid, and finfish.||Hypotension, tachycardia, decreased skin turgor. Rice-water stools|
|Parasites||Protozoa||Giardia lamblia||2-5 y||+||1 cyst||1-2 we||-||-||+||+||+||Contaminated water||May cause malabsorption syndrome and severe weight loss|
|Entamoeba histolytica||4-11 y||+||<10 cysts||2-4 we||-||+||+||+||+||Contaminated water and raw foods||May cause intestinal amebiasis and amebic liver abscess|
|Cryptosporidium parvum||Any ages||-||10-100 oocysts||7-10 d||+||+||+||+||+||Juices and milk||May cause copious diarrhea and dehydration in patients with AIDS especially with 180 > CD4|
|Cyclospora cayetanensis||Any ages||+||10-100 oocysts||7-10 d||-||+||+||+||+||Fresh produce, such as raspberries, basil, and several varieties of lettuce.||More common in rainy areas|
|Helminths||Trichinella spp||Any ages||-||Two viable larvae (male and female)||1-4 we||-||+||+||+||+||Undercooked meats||More common in hunters or people who eat traditionally uncooked meats|
|Taenia spp||Any ages||-||1 larva or egg||2-4 m||-||+||+||+||+||Undercooked beef and pork||Neurocysticercosis: Cysts located in the brain may be asymptomatic or seizures, increased intracranial pressure, headache.|
|Diphyllobothrium latum||Any ages||-||1 larva||15 d||-||-||-||+||+||Raw or undercooked fish.||May cause vitamin B12 deficiency|
8Small bowel diarrhea: watery, voluminous with less than 5 WBC/high power field
Large bowel diarrhea: Mucousy and/or bloody with less volume and more than 10 WBC/high power field
† It could be as high as 1000 based on patient's immunity system.
|Diverticulitis||Abdominal CT scan with oral and intravenous (IV) contrast||bowel rest, IV fluid resuscitation, and broad-spectrum antimicrobial therapy which covers anaerobic bacteria and gram-negative rods|
|Ulcerative colitis||Endoscopy||Induction of remission with mesalamine and corticosteroids followed by the administration of sulfasalazine and 6-Mercaptopurine depending on the severity of the disease.|
|Entamoeba histolytica||cysts shed with the stool||detects ameba DNA in feces||Amebic dysentery
For amebic liver abscess:
- "http://phil.cdc.gov/phil/details.asp". External link in
- "http://phil.cdc.gov/phil/details.asp". External link in
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