Figure 1068

Cryptosporidia, Isospora, cyclospora, and microsporidia are intestinal spore-forming protozoa that infect enterocytes predominately of the small intestine. Infection occurs by ingesting the spores (oocytes) by person-to-person contact or ingesting contaminated food or water, including city or swimming pool water [32]. Infections in immunocompetent individuals may be asymptomatic or self-limited and associated with mild to moderate diarrhea and, less frequently, nausea, abdominal cramping, vomiting, and fever.

In immunodeficient patients, especially those with T-cell impairment, the infections may cause severe persistent diarrhea. The most common infection among the intestinal protozoas is cryptosporidi-um. The general prevalence of cryptosporidia in stool specimens in Europe and North America is 1% to 3%, and in Asia and Africa is 5% to 10%. Antibodies to cryptosporidia, however, have been found in 32% to 58% of adults. (Adapted from Goodgame [33]; with permission.)

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