1. Background

• Cryptosporidium is an intestinal parasite of the same family as toxoplasma. The life cycle (asexual->sexual stage) is completed within 12 days within one host who ingests the oocytes and sub-sequently passes on more infected oocytes. It is primarily an animal pathogen (zoonate) transmitted by the fecal-oral route. This illness is more common and serious in immunocomprimised patients (AIDS) in whom it can produce a voluminous watery stool. Outbreaks have also been identified in day-care centres.
• Cryptosporidium is the 2nd most common pathogen to campylobacter in acute infectious diarrhea and is more common than salmonella and shigella*
• The rate of hospitalization of children with crytosporidium is 35% (infants), 19% (1-4 yrs), and 22% (5-14 yrs)
• Positivity rates for crytosporidium correlates closely with isolation rates for campylobacter & salmonella but not shigella

1. Diarrhea

• watery (sometimes cholera-like)
• maximum frequency of stools: 6/day
• duration of diarrhea: 9-12 days
• profound diarrhea (>21 days) were reported in only 45/62,421 patients of which 60% were aged 1-4 yrs

2. Associated Symptoms

• watery diarrhea
• abdominal cramps
• vomiting
• anorexia
• fever

3. Complications

• dehydration with severe weight loss
• malabsorption with anorexia
• abdominal pain may persist for up to 4 weeks

1. Stool

• oocytes found with modified acid-fast stain (modified Ziehl-Nelson method)

2. Biopsy

• crytosporidium may be visible adherent to the intestinal mucosa with light or electron microscopy