Cyclosporiasis Clinical Presentation

Updated: Aug 08, 2017
  • Author: Shipra Gupta, MD; Chief Editor: Russell W Steele, MD  more...
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Diarrhea is the hallmark of cyclosporiasis. Onset is abrupt, 1-14 days after exposure to a contaminated source. The diarrhea is described as profuse, malodorous, and watery and can cause dehydration and weight loss. Diarrhea may be associated with 1 or more nonspecific symptoms, including intermittent crampy abdominal pain, nausea, vomiting, low-grade fever, malaise, myalgias, anorexia, bloating, flatulence, and/or profound fatigue. These symptoms are indistinguishable from those of Isospora and Cryptosporidium infections.

In an immunocompromised host, onset is more insidious, and the condition becomes chronic; symptoms and shedding of oocysts continue indefinitely.

Extraintestinal complications are uncommon. Acalculous cholecystitis with right upper quadrant pain, elevated alkaline phosphatase, and thickened gallbladder on ultrasound findings has been reported in an immunocompromised host infected with Cyclospora. [20, 21, 22] Cyclospora infections have been rarely associated with Reiter's syndrome and Guillain–Barré syndrome. [23, 24] Recurrences are common in immunocompromised hosts.

In an immunocompetent host, diarrhea can persist for 7 days to several weeks, with a waxing and waning course.



Physical examination findings are unremarkable, other than signs of dehydration or, in an immunocompromised host, biliary disease.



Causes of cyclosporiasis include consumption of infected water or produce or exposure to the organism during travel to countries where it is endemic. Immunosuppression is a risk factor for chronic cyclosporiasis in endemic areas or among travelers to these areas. [25]