Treatment and prevention of cryptosporidiosis
- Karin Leder, MBBS, FRACP, PhD, MPH, DTMH
Karin Leder, MBBS, FRACP, PhD, MPH, DTMH
- Section Editor — Travel Medicine
- Head of Infectious Diseases Unit
- Monash University, Australia
- Peter F Weller, MD, FACP
Peter F Weller, MD, FACP
- Editor-in-Chief — Infectious Diseases
- Section Editor — Tropical Medicine
- William Bosworth Castle Professor of Medicine
- Harvard Medical School
- Professor of Immunology and Infectious Diseases
- Harvard T. H. Chan School of Public Health
Cryptosporidium is an intracellular protozoan parasite that is associated with self-limited diarrhea in immunocompetent hosts and severe debilitating diarrhea with weight loss and malabsorption in immunocompromised patients (eg, patients with AIDS). The approach to treatment for patients with cryptosporidiosis depends upon the immune status of the host as well as the severity of symptoms.
This topic will address the treatment and prevention of cryptosporidiosis in immunocompetent and HIV-infected patients. The epidemiology, pathogenesis, clinical manifestations, and diagnosis of cryptosporidiosis are found elsewhere. (See "Epidemiology, clinical manifestations, and diagnosis of cryptosporidiosis".)
Most patients with cryptosporidiosis have mild to moderate symptoms and are able to keep up with their fluid losses without the need for additional therapies. However, for patients with severe, prolonged symptoms, supportive care includes:
●Antidiarrheal agents — Loperamide is often used for control of diarrhea. However, tincture of opium may be more effective than loperamide .
●Enteral or parenteral nutrition — Repletion of electrolyte losses by either oral or intravenous routes is important in patients who experience significant volume loss associated with severe diarrhea. Volume loss of >10 liters per day has been reported in patients with "cholera-like" diarrhea, which can be life-threatening without aggressive repletion . In patients with chronic symptoms and weight loss, total parenteral nutrition should also be considered. Additional discussions of fluid management are found elsewhere. (See "Overview of cholera", section on 'Fluid management' and "Oral rehydration therapy".)
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