Protozoan Phylum: Apicomplexa Class: Sporozoasida Order: Eucoccidiida Family Cryptosporiidae Genus: Criptosporidium waterfilterreview.com Species: parvum, muris, meleagridis, felis, etc.
Recognized in mice in 1907 Reported in humans in 1976 Immunocompetent child Immunosuppressed adult Recognized globally in 1980s and 1990s www.nap.edu AIDS patients Ernest Edward Tyzzer Outbreak among veterinary students
Cryptosporidium is a spore producing parasite found in the intestine of infected people and animals. Cryptosporidium spp. is landesbioscience.com the most common cause of Cryptosporidiosis.
Infection Ingesting food or drinks contaminated with fecal material Swallowing recreational water contaminated with secretsofsoa.com Cryptosporidium Not washing hands Sexual practices leading to oral exposure with fecal material victorystore.com
Buries into intestinal lining of the gut Goes through Life Cycle Alters osmotic pressure Diarrhea Atrophy of intestinal villi Alters uptake of fluids, electrolytes, and nutrients Malabsorption syndrome CDC DPDx Library
Symptoms (2 to 10 days after infection and can last up to 30 days) Diarrhea Stomach cramps treehugger.com Dehydration Nausea Vomiting Fever Weight loss Sometimes no symptoms are seen bathroomscalereview.com
Visualization of Oocysts 4 to 6 µm Bight-Field Microscopy Differential Interference contrast (DIC) High Sensitivity and CDC DPDx Library Specificity Wet Mount Slide
Visualization of Oocytes Light pink to dark red Can also visualize sporozoites Relatively High Sensitivity and Specificity Irregular Staining CDC DPDx Library cause “ghost” oocysts Modified Acid Fast Stain
Fluorescence microscope “Gold Standard” High sensitivity and specificity Does not provide archievable stained slide Requires special equipment CDC DPDx Library Fluorescent Stain Auramine Rhodamine
Safranin stain Oocysts stain a bright red orange Not widely used because oocysts may not stain properly Trichrome Stain CDC DPDx Library Safranin Stain Oocysts may appear unstained Lowest sensitivity and specificity among all tests Can detect Oocysts, but Cryptosporidium should be confirmed by diagnostic CDC DPDx Library techniques Trichrome Stain
Detects isolated antigens from a patients sample using antibodies that are tagged with a color changing enzyme. Relatively high Sensitivity and Specificity Does not involve microscopy techlab.com Screens large numbers of specimens
Separates DNA fragments based on size 435 bp High Sensitivity and Specificity CDC DPDx Library
Detects isolated antigens from sample using antibodies. A positive test is indicated by a colored bar. Variable Sensitivity and alibaba.com Specificity Some Assays Have Been Recalled
Nitazoxanide Paromomycin Azithroycin Individuals with AIDS anti-retroviral therapy generecsmed.com
Ashton-Rickardt, P.G. A license to remember. Nat. Immunol. 5, 1097-1098 (2004). Beach, M.J. And Johnston, S. P. Manufacturers recall of rapid cartridge assay kits on the basis of false-positive Cryptosporidium antigen tests — Colorado. MMWR. 53, 198-199 (2004). CDC. http://www.cdc.gov/parasites/crypto/. Accessed September 22, 2011 Dillingham, R. A., Aldo, A. A., and Guerrant, R. L. Cryptosporidiosis: epidemiology and impact. Microb. Infect. 4, 1059-1066 (2002). Mahon, C.R., Lehman, D.C., and Manuselis, G. Textbook of Diagnostic Microbiology. 4th Ed. Elsevier (2011) Riggs, M. W. Recent Advances in cryptosporidiosis: the immune response. Microb. Infect. 4, 1067-1080 (2002). Stevens, C.D. Clinical Immunology & Serology: A Laboratory Perspective. 3rd Ed. F.A. Davis Company (2010). Tzipori, S. and Honorine, W. Cryptosporidiosis: biology, pathogenesis and disease. Microb. Infect. 4, 1047-1058 (2002).