Clinical Information

Cyclospora cayetanensis is an apicomplexan protozoan parasite that causes watery diarrhea, anorexia, malaise, and weight loss. The extent of symptoms depends on the age and condition of the host and the infectious dose. The infection is usually self-limited, but symptoms can be severe and prolonged, particularly in immunocompromised patients. Cyclosporal diarrheal disease is endemic in many parts of the world, including Asia, India, Southeast Asia, and Latin America. Although most cases of cyclosporiasis have been seen in travelers to developing countries, outbreaks in the United States have been noted due to contaminated fruits and vegetables from Latin America. Transmission is via fecally contaminated food or water. If untreated, symptoms typically last for 10 to 12 weeks, and may follow a relapsing course. The infection usually responds to treatment with a sulfamethoxazole-trimethoprim drug combination.

Cyclospora cayetanensis oocysts are traditionally detected by modified acid-fast staining, in which the oocysts stain bright pink-red. However, the modified safranin stain has been shown to provide increased sensitivity over modified acid-fast method and produces a more rapid result. It is the method used in our laboratory to detect Cyclospora cayetanensis oocysts in fecal sediment.

See Laboratory Testing for Infectious Causes of Diarrhea and Parasitic Investigation of Stool Specimens Algorithm for other diagnostic tests that may be of value in evaluating patients with diarrhea.