Cryptosporidiosis

Cryptosporidiosis

Article
Digestive Health
Diseases & Conditions
+1
Contributed byMaulik P. Purohit MD MPHAug 15, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Crypto
  • Cryptosporidiidae
  • Cryptosporidium Enteritis

What is Cryptosporidiosis? (Definition/Background Information)

  • Cryptosporidiosis is an infection of the small intestine caused by the microscopic parasite Cryptosporidium. The parasite is found in soil, water, food, or surfaces contaminated with the feces from infected humans or animals; a contact with the parasite can cause the infection
  • Cryptosporidiosis is common among all age groups. However, the condition is more prevalent in individuals affected by immune disorders, or those who have had organ transplants and are under immunosuppressant medication
  • Some risk factors for contracting Cryptosporidiosis include drinking contaminated water, coming in contact with infected individuals, homosexual men, and drinking unpasteurized cider. Children are more vulnerable to the condition
  • Cryptosporidiosis is characterized by acute, watery, non-bloody diarrhea. Abdominal pain, nausea, weakness, and weight loss are some other symptoms associated with the condition. Complications arising from Cryptosporidiosis could include other infections and scarring of internal organs
  • Generally, stool samples over several days are analyzed by various methods to detect the presence of the parasite, to arrive at an accurate diagnosis
  • Typically, individuals with Cryptosporidiosis are treated with plenty of fluids, anti-parasitic medication, and medication to slow down the intestinal spasms
  • The best method of preventing Cryptosporidiosis is to practice good hygiene. This includes washing raw vegetables and fruits thoroughly, cooking to proper temperatures, etc. can reduce the chances of contracting the condition. Avoiding swimming in waters that are contaminated with feces is another method of avoiding the infection

Who gets Cryptosporidiosis? (Age and Sex Distribution)

Cryptosporidiosis affects individuals of any age, though it is frequently found in:

  • Those with a weakened immune system
  • Individuals on medicines to suppress their immune systems
  • HIV or AIDS affected individuals
  • Those who have undergone organ transplants
  • Young children

What are the Risk Factors for Cryptosporidiosis? (Predisposing Factors)

The following are some of the risk factors associated with Cryptosporidiosis:

  • Swallowing water which is contaminated with feces, especially while swimming in contaminated pools and lakes
  • Handling animals regularly (such as in vet clinics, zoos, etc.)
  • Men having sex with men
  • Coming in close contact with infected individuals
  • Drinking from contaminated public water supplies
  • Drinking unpasteurized cider

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Cryptosporidiosis? (Etiology)

Cryptosporidiosis is an infection of the small intestine caused by the microscopic parasite Cryptosporidium. It can be found in the intestines of humans and contaminate soil, water, or food through the fecal route. Surfaces may be contaminated with feces from infected humans or animals and lead to the transmission of the disease.

The following factors may play a role in the spread of Cryptosporidiosis:

  • Accidentally ingesting the parasite or swallowing something that has come in contact with the stool of an infected person or animal
  • Swallowing contaminated water (with Crypto) that is found in swimming pools, hot tubs, fountains, lakes, rivers, ponds, and streams.
  • Swallowing contaminated drinking water or beverage
  • Eating uncooked (raw) food contaminated with Cryptosporidium
  • By touching one’s mouth with contaminated hands.
  • Exposure to human feces through sexual contact
  • Close contact with other infected individuals, allowing the parasite to be transmitted from the hand to the mouth
  • Eating food that has been washed with contaminated water

What are the Signs and Symptoms of Cryptosporidiosis?

The following are the some known symptoms exhibited following the onset of Cryptosporidiosis:

  • Watery diarrhea
  • Stomach cramps/pain
  • Nausea, vomiting
  • Slight fever
  • Weakness
  • Weight loss
  • Dehydration
  • Malabsorption

How is Cryptosporidiosis Diagnosed?

The diagnosis of Cryptosporidiosis may involve a physical exam and evaluation of medical history. However, the general method for diagnosing Cryptosporidiosis is by performing a stool sample analysis. Several stool samples over several days may be tested to confirm Cryptosporidiosis.

Stool specimens are examined microscopically using different techniques such as:

  • Acid-fast staining test
  • Direct fluorescent antibody (DFA) test
  • Enzyme immunoassays
  • Molecular methods such as:
    • Polymerase chain reaction (PCR)
    • Stool culture
    • Checking liver and gall bladder function

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Cryptosporidiosis?

The complications that may arise from Cryptosporidiosis could include:

  • Sclerosing cholangitis: Swelling, scarring, and destruction of the bile ducts of the lever
  • Acalculous cholecystitis - an inflammatory condition affecting the gall bladder
  • Papillary stenosis: Disturbances of the muscular valve that prevents the opening and closing of bile fluids into the duodenum
  • Pancreatitis: Inflammation of the pancreas, especially in those with poor immune systems
  • Respiratory tract infection in AIDS patients
  • Severe malnutrition as a result of non-stop and heavy diarrhea
  • Cognitive function abnormalities in young children
  • The condition may also become chronic  and potentially result in biliary tract disease, chronic malnutrition, and even death

How is Cryptosporidiosis Treated?

There is no specific treatment for Cryptosporidiosis infection. Typically, affected individuals are advised to take plenty of fluids to prevent dehydration. Additionally, the following treatment methods may be considered:

  • Fluid and electrolyte replacement therapy for infants and children - either oral or intravenous replacement may be done to prevent dehydration
  • Use of anti-parasitic drugs: Also, anti-parasitic therapy combined with symptomatic treatment including nutritional therapy can help avoid severe malnutrition
  • If the gallbladder is severely affected then a cholecystectomy may be performed
  • Anti-motility drugs may be used to slow the movement of the intestine and increase fluid absorption, which can help reduce the incidence of diarrhea
  • Anti retroviral therapy for HIV and AIDS patients: Highly-active anti-retroviral therapy (HAART) can help reduce the viral load in the body and boost the immune system 

How can Cryptosporidiosis be Prevented?

The following preventive measures may be helpful in reducing the risk of contracting Cryptosporidiosis:

  • Practicing good hygiene such as washing hands with soap and water after using toilet, changing diapers, before and after eating, etc.
  • Washing and peeling raw vegetables and fruits before consuming them
  • Avoiding the consumption of contaminated food
  • Purifying drinking water before use using methods such as boiling and filtration
  • Limiting swimming activities in contaminated or unclean water bodies; avoiding swallowing water while swimming
  • Avoiding fecal exposure during sex
  • Handling domestic animals with care (such as washing hands while and after handling them)
  • Isolation: Children with diarrhea should not be sent to school or daycare center until the diarrhea is under control
  • Showering before and after entering a swimming pool
  • Wearing gloves while gardening
  • Not touching the stool of pets

Note: The chemical disinfection of Cryptosporidium may not be successful, since it is highly-resistant to inactivation by chlorine and iodine.

What is the Prognosis of Cryptosporidiosis? (Outcomes/Resolutions)

  • In healthy individuals, Cryptosporidiosis resolves itself after the bouts of diarrhea
  • However, individuals, who are immunocompromised, have prolonged diarrhea, or biliary disease could potentially have a poor outcome

Additional and Relevant Useful Information for Cryptosporidiosis:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/diseases-conditions/infection-center/

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Maulik P. Purohit MD MPH picture
Approved by

Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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