Cryptosporidium is an protozoa that can cause diarrhea. Cryptosporidium is mostly commonly seen in HIV positive patients and is the most common cause of chronic diarrhea in HIV patients. Cryptosporidium oocysts are 4-6 µm in diameter and exhibit partial acid-fast staining.
Environmental exposures include: People who swim regularly in pools with insufficient sanitation, hikers who drink untreated water, people who handle infected cattle.
Symptoms usually appear one week after infection which include:
- watery diarrhea
- stomach cramps/pain
- weight loss
- Viral (e.g. rotavirus)
- GI Bleed
- Mesenteric Ischemia
- Adrenal Crisis
- Thyroid Storm
- Toxicologic exposures
- Antibiotic or drug-associated
- Enterotoxigenic E. coli (most common cause of watery diarrhea)
- Norovirus (often has prominent vomiting)
- Non-typhoidal Salmonella
- Enteroaggregative E. coli (EAEC)
- Enterotoxigenic Bacteroides fragilis
- Stool acid-staining test
- Stool Culture
- If patient non-sick appearing and not immunocompromised, medication often not needed
- Antiparasitics such as nitazoxanide for immunocompromised patients
- IV/PO hydration if dehydration present
- If patient not on HAART therapy, consider contacting HIV/ID for initiating therapies
- Most of these patient's can be discharged with close PMD/HIV follow up.
- If patient has electrolyte abnormalities or severely dehydrated consider observation placement vs admission for rehydration therapy
- Marx et al. “Cholera and Gastroenteritis caused by Noncholera Vibrio Species”. Rosen’s Emergency Medicine 8th edition vol 1 pg 1245-1246.