Health Encyclopedia

Cryptosporidium enteritis

Definition

Cryptosporidium enteritis is an infection of the small intestine that is caused by the parasite cryptosporidium. The main symptom is diarrhea.

Alternative Names

Cryptosporidiosis

Causes, incidence, and risk factors

Cryptosporidium has recently been recognized as a worldwide cause of diarrhea in all age groups. Its major impact has been among those with weakened immune systems, including:

People who take medications to suppress their immune system
People with HIV or AIDS
Transplant recipients

In these groups, this diarrheal infection is not just bothersome. It also can lead to severe, and potentially life-threatening, loss of muscle and body mass (wasting) and malnutrition.

The major risk factor is swallowing water contaminated with fecal matter. Those at higher risk include:

Animal handlers
Men who have sex with men
People in close contact with infected individuals
Young children

Outbreaks have been linked to:

Drinking from contaminated public water supplies
Drinking unpasteurized cider
Swimming in contaminated pools and lakes

Symptoms

Abdominal cramping
Malaise
Malnutrition and weight loss (in severe cases)
Nausea
Watery diarrhea, usually large-volume and multiple times a day

Signs and tests

Antibody test to see if cryptosporidium are in the stool
Intestinal biopsy (rare)
Special staining of the stool (called AFB staining)
Stool ova and parasites exam using a microsope

Treatment

There is no one treatment for cryptosporidium enteritis.

Drugs such as nitazoxanide have been used in children and adults. Other drugs that are sometimes used include:

Paromomycin
Trimethoprim-sulfamethoxazole
Metronidazole
Atovaquone
Azithromycin are sometimes used

However, these drugs usually only help for a little while.

Right now, the best approach is to improve the immune status in people who have a weakened immune system. This can be done, for example, by using highly active antiviral therapy in people with AIDS.

AIDS specialists and patient activists may provide additional information on the latest treatments, and on medications and alternative treatments that may provide some relief.

Expectations (prognosis)

In healthy people, the infection will clear up but can last up to a month. In people who are immunosuppressed, prolonged diarrhea may cause loss of body weight and malnutrition.

Complications

Cholangitis (inflammation of a bile duct), cholecystitis (inflammation of the gallbladder)
Hepatitis
Pancreatitis
Severe malabsorption (not enough nutrients being absorbed from the intestinal tract)
Wasting syndrome (loss of body mass where the person becomes very thin and weak)

Calling your health care provider

Notify your health care provider if you develop watery diarrhea that does not go away within a few days, especially if you are immunosuppressed.

Prevention

Proper sanitation and hygiene, including handwashing, are important measures in the prevention of this illness.

Certain water filters can also reduce risk by filtering out the eggs of the cryptosporidium organism. However, the pores of the filter must be smaller than 1 micron to be effective. If you are immunosuppressed, ask your doctor if you need to boil your water.

References

Montes M, DuPont HL. Enteritis, Enterocolitis and Infectious Diarrhea Syndromes. In: Cohen J, Powderly WG, Berkley SF, et al, eds. Infectious Diseases. 2nd ed. Philadelphia, PA: Mosby Elsevier; 2004: chap 43.

Kirkpatrick BD, Sears CL. Cryptosporidiosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, PA: Saunders Elsevier; 2007: chap 371.

Review Date:5/19/2008
Reviewed By:Sean O. Stitham, MD, private practice in Internal Medicine, Seattle, WA; Jatin M. Vyas, MD, PhD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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