ANTIFUNGAL MEDICATIONSto treat severe symptoms
or cryptococcosis in people who are immunocom-
promised (including those who have HIV/AIDS);
long-term treatment may be necessary.
ANTIFUNGAL MEDICATIONS
TO TREAT CRYPTOCOCCOSIS
amphotericin B fluconazole flucytosine
See also CANDIDIASIS; COCCIDIOIDOMYCOSIS; CRYP-
TOSPORIDIOSIS; OPPORTUNISTIC INFECTION.
cryptosporidiosis An illness that results from
INFECTIONwith the PARASITECryptosporidium parvum,
which lives in the gastrointestinal tract of numer-
ous animals and passes into the environment, pri-
marily bodies of fresh water such as rivers and
lakes, through the feces. The parasites form cysts
that are highly resistant even to chemical disinfec-
tants such as chlorine.
People acquire infection with C. parvum
through drinking or unintentionally swallowing
(such as when swimming) contaminated water.
The parasites may also be present in foods rinsed
or prepared with contaminated water. The INCUBA-
TION PERIODis 2 to 10 days and the illness lasts
about 2 weeks. During the incubation period and
when symptoms are present, the infection is con-
tagious and the person may pass it to others.
Proper HAND WASHINGand other PERSONAL HYGIENE
measures are essential to reduce this risk.
The primary symptom of cryptosporidiosis is
profuse, watery DIARRHEA. In addition to the diar-
rhea, many people have abdominal cramping and
low-grade FEVER. Treatment is supportive, empha-
sizing fluid replacement to prevent DEHYDRATION
due to the diarrhea. People who are IMMUNOCOM-
PROMISEDmay require hospitalization for adequate
fluid replacement and medical management of the
diarrhea. Most otherwise healthy people fully
recover after the infection runs its course.
See also AMEBIASIS; CYCLOSPORIASIS; DRINKING
WATER STANDARDS; FOODBORNE ILLNESSES; GIARDIASIS;
OPPORTUNISTIC INFECTION; WATERBORNE ILLNESSES.
cyclosporiasis An illness that results from INFEC-
TIONwith the PARASITECyclospora cayetanensis.The
Cyclosporacome to maturity in warm, moist envi-
ronments after excretion in the feces of people
who have the infection. This parasite, unlike most,
cannot cause immediate infection so people who
are infected are not contagious. People acquire
infection with Cyclosporathrough eating foods or
drinking water contaminated with the parasites.
The Cyclosporainfect the SMALL INTESTINE, causing
abdominal cramping and watery DIARRHEA. Some
people also have low-grade FEVERand generalized
discomfort.
The incubation period (time from infection to
illness) is five to seven days. Diagnosis is through
laboratory examination of stool samples, which
reveals the Cyclosporacysts. Treatment is a course
of therapy with ANTIBIOTIC MEDICATIONS, usually the
combination antibiotic drug trimethoprim-sul-
famethoxazole (TMP-SMZ), along with diligent
rehydration. Most people recover rapidly and
completely with treatment. Without treatment,
relapses of symptoms are common and can con-
tinue over a period of several months before full
recovery occurs.
See also COCCIDIOIDOMYCOSIS; CRYPTOCOCCOSIS;
CRYPTOSPORIDIOSIS; FOODBORNE ILLNESSES; FOOD
SAFETY; OPPORTUNISTIC INFECTION; WATERBORNE ILL-
NESSES.cytomegalovirus (CMV) A member of the her-
pesvirus family, also called human herpesvirus-5
(HHV-5). Like other herpesviruses, CMV is ubiqui-
tous throughout the world—85 percent of Ameri-
cans have CMV INFECTION by age 40. However,
CMV infection primarily causes illness only in
people who are IMMUNOCOMPROMISED, such as peo-
ple who have HIV/AIDS or who take long-term
IMMUNOSUPPRESSIVE THERAPYafter ORGAN TRANSPLAN-
TATION. CMV is also a significant risk for the
unborn child of a woman whose initial infection
with the VIRUS occurs during PREGNANCY. CMV
virus crosses the PLACENTA to the fetus, causing
congenital CMV infection. Most infants are born
unharmed; however, CMV infection can affect
hearing, vision, and intellectual capacity.
When CMV infection causes illness, symptoms
typically include NAUSEA, VOMITING, DIARRHEA, JAUN-
DICE, andFEVER. The person often has an enlarged
and tender LIVER (HEPATOMEGALY) and SPLEEN
(SPLENOMEGALY). Doctors may suspect infectious
mononucleosis or HEPATITIS, though tests for these
conditions come back negative. A BLOODtest can320 Infectious Diseases