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CRYPTOSPORIDIOSIS

Cryptosporidia is a parasite that can cause diarrhoea in humans. It was first identified in 1907 in animals and was recognized as a major cause of diarrhoea and death in AIDS patients in the 1980s. Cryptosporidia infects intestinal cells and attaches without penetrating them, damaging microvilli and causing diarrhoea. Symptoms include watery diarrhoea and weight loss. It is transmitted when sporulated oocysts are ingested in contaminated food or water.

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62 views

CRYPTOSPORIDIOSIS

Cryptosporidia is a parasite that can cause diarrhoea in humans. It was first identified in 1907 in animals and was recognized as a major cause of diarrhoea and death in AIDS patients in the 1980s. Cryptosporidia infects intestinal cells and attaches without penetrating them, damaging microvilli and causing diarrhoea. Symptoms include watery diarrhoea and weight loss. It is transmitted when sporulated oocysts are ingested in contaminated food or water.

Uploaded by

Orakle mkhwanazi
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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CRYPTOSPORIDIA

ESSENTIAL DIAGNOSIS
Mild to watery diarrhoea
Abdominal cramps, anorexia, weight loss,
vomiting
INTRODUCTION
1stidentified in 1907 as a species of animals
1sthuman case reported in 1976 –
characterized as associated with
immunosuppression
Accepted as a major cause of diarrhoea and
death in AIDS patients in the early 80s
Now recognised as a cause of diarrhoea in
immunocompetent persons as well
Approx. 4% of AIDS patients reported at
CDC had cryptosporidiosis
INTRODUCTION
Two species cause human disease:
1. Cryptosporidium parvum
2. Cryptosporidium hominis (also associated
with pig infections)
LIFE
CYCLE
PATHOGENESIS
Cryptosporidia infects cells of the
intestinal mucosa, lamina propria and
may be found multiplying in lymph
nodes
Parasite does not penetrate epithelial cells
but attaches to them forming a “feeder
organelle” or “adhesion zone” through
which nutrients are absorbed
PATHOGENESIS
Cryptosporidia cover and replace microvilli
Diarrhoea is osmotic, inflammatory and
secretory
Enterotoxin has been suggested but no
evidence has been produced
Microvilli are damaged, leading to villous
atrophy and hyperplasia
Na+ absorption decreases
Cl- absorption increases
PATHOGENESIS
Infected epithelial cells are damaged,
particularly the villi (villus atrophy or
blunting)
Crypt hyperplasia (division and
enlargement of cells to replace damaged
cells) and inflammation occurs
Damaged villi fail to absorb digested food
resulting to osmotic diarrhoea
PATHOGENESIS
Immunocompetent persons: jejunum and
ileum
Immunodeficient persons: stomach,
jejunum, ileum, duodenum, colon and
biliary tract
Lower CD4 cell counts correlates with
severity of disease
SYMPTOMS
Most patients are asymptomatic
Symptoms commonly show in
immunocompromised groups
However, there is also an increase of
infections noticed in immunocompetent
persons
SYMPTOMS
Include diarrhoea – may be mild,
chronic or acute
Steatorrhoea, headache, fever, abdominal
pain, nausea, dehydration and weight loss
Symptoms commonly severe in infants
and young children
AIDS PATIENTS
Diarrhoea is usually very watery requiring
hospitalisation
Diarrhoea may be chronic, lasting months to
years
Fever, malabsorption & excessive weight
loss at a higher level than in
immunocompetent individuals, commonly
resulting to electrolyte imbalance or death
Reports of extra-intestinal disease has been
received
DIAGOSIS
Identification of C. parvum oocysts in faecal
smears stool using a microscope
Organisms are very small and difficult to
see, particularly in routine diagnosis
Oocysts may be concentrated by floating
faeces in sucrose solution
Biopsy of intestines may recover stool rich in
organisms
Serologic assays are used for field studies or
surveillance
TREATMENT
Paromomycin
nitazoxanide
Improvement of immunosuppression may
clear diarrhoea
EPIDEMIOLOGY AND
TRANSMISSION
Transmission occurs when sporulated
oocysts are ingested in contaminated food
or water (particularly recreational water
such as swimming pools and naturally
heated pools)
Animal-to-human transmissions are
important e.g. cats, cattle, etc.
PREVENTION AND CONTROL
Promotion of public and personal hygiene,
especially washing hands after handling
animals or animal faeces including after
visiting the toilet and before handling food.
Dispose of all faeces in a sanitary manner.
Exercise extra care when handling animal
faeces.
Promotion of hand-washing habits among
those coming in contact with calves and
other animals with diarrhoea.
PREVENTION AND CONTROL
Filter or boil drinking water; chemical
disinfectants (chlorination or iodination)
are not effective against oocysts.
Stringent precautions should be taken
when handling faeces, vomitus and
contaminated clothing and bed linen of
infected individuals; symptomatic
individuals should also be excluded from
food preparation activities.

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