Cyclospora Infection (Cyclosporiasis) (cont.)

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How is Cyclospora infection diagnosed?

The diagnosis of Cyclospora is made by examining stool samples. Using a light microscope, the stool is examined for oocysts. Occasionally, more than one sample must be used to find oocysts. These samples should usually be 24 to 48 hours apart because oocysts are sometimes shed intermittently in stool. To increase the ability to diagnose Cyclospora, special staining methods, polymerase chain reaction (PCR) tests, and stool specimen concentration techniques are used. Physicians should alert the laboratory if Cyclospora is suspected so that these methods can be used. Currently, there is no blood test that can detect Cyclospora.

What is the treatment of Cyclospora infections?

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Cyclospora infection is self-limited, and mild or asymptomatic cases require no treatment. For those who require treatment, the best option is oral trimethoprim-sulfamethoxazole (TMP-SMX) (Bactrim, Septra) twice daily for seven days. For those who continue to have symptoms or have persistent oocysts on stool examination, another seven-day course is usually effective in clearing infection. For patients with a sulfa allergy, there are few good alternatives. There are reported cases where nitazoxanide (Alinia) twice daily was successful as an alternate therapy, although large-scale studies have not been done. One small study suggested that ciprofloxacin (Cipro, Cipro XR, Proquin XR) twice daily for seven days is an option in adults, but it has a higher failure rate compared to TMP-SMX and some have questioned its effectiveness. Because these medications are not approved for routine use during pregnancy, treatment of pregnant patients should be individualized and done in consultation with an obstetrician.

Medically Reviewed by a Doctor on 12/24/2013

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