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Clinical Features:
Infection causes
acute, nonbloody diarrhea with crampy abdominal pain, which can last for weeks and result
in malabsorption and weight loss. In immunodepressed patients, and in infants and
children, the diarrhea can be severe. Eosinophilia may be present (differently
from other protozoan infections).
Laboratory
Diagnosis:
Microscopic demonstration of the
large, typically shaped oocysts, is the basis for diagnosis. Because the oocysts may
be passed in small amounts and intermittently, repeated stool examinations and
concentration procedures are recommended.
If stool examinations are negative, examination of duodenal specimens by biopsy or string
test (Enterotest®) may be needed.
The oocysts can be visualized on wet mounts by microscopy with bright-field, differential
interference contrast (DIC), and epifluorescence. They can also be stained by
modified acid-fast stain.
Diagnostic findings
Treatment:
Trimethoprim-sulfamethoxazole
is the drug of choice. See recommendations in The Medical Letter for complete information.
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