A patient who is immunodeficient is susceptible to infection with Cyclospora cayetanensis.
Susceptible populations:
(1) HIV positive
(2) congenital immunodeficiency
(3) acquired immunodeficiency (organ transplant, other)
Common history:
(1) living in or travel to developing country, especially Southeast Asia, India, South America and Africa
(2) eating fresh fruits and vegetables and/or drinking untreated water
(3) traveler's diarrhea, which may be watery
An important feature of infection in an immunodeficient patient is prolonged diarrhea.
Diagnosis:
(1) Fecal microscopic examinations can have false negative.
(2) PCR can be diagnostic but may not be specific if travel was recent and may not be available.
(3) If the diagnosis is suspected and if fecal microscopic examinations are negative, then biopsy of the terminal ileum and/or duodenum may be required.
Co-infection with other parasites may be present, which can lead to a delay in diagnosis of the cyclosporosis.
