Internal Medicine

0521779407-C04 CUNY1086/Karliner 0 521 77940 7 June 14, 2007 20:37

448 Cyclosporiasis

Signs & Symptoms

■Watery diarrhea, nausea, vomiting, abdominal cramps, belching,

sometimes fever. Abdominal exam may show mild tenderness, dis-

tention. Symptoms last 6–7 weeks.

tests

■Basic tests: blood: usually normal

■Basic tests: urine: normal

■Specific tests: Stool O&P examination, using acid-fast staining. May

need several stools.

■Other tests: not easily detected by small bowel biopsy

differential diagnosis

■Other causes of watery diarrhea, especially giardiasis, isosporiasis,

cryptosporidial infection, travelers’ diarrhea

management

What to Do First

■Assess need for fluid and/or electrolyte therapy.

General Measures

■Assess source of infection.

specific therapy

Indications

■All symptomatic patients

Treatment Options

■Trimethoprim-sulfamethoxazole for 7 days. Treat for 10 days in

immunosuppressed patients.

Side Effects & Complications

■Allergy to sulfa component may occur. Sometimes GI upset from

medications.

■Contraindications to treatment: absolute: allergy to medications

■Contraindications to treatment: relative: asymptomatic patients

follow-up

During Treatment

■Observe for tolerance of meds.

Routine

■Stool examination 2–3 weeks after completing therapy