NYDOH Cyclospora Health Advisory: Clinicians Advised to Consider Targeted Testing for Persistent Diarrheal Illness
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Physicians are reminded to consider Cyclospora cayetanensis infection in patients presenting with prolonged or relapsing watery diarrhea, particularly those with a history of consuming fresh imported produce or recent travel to tropical or subtropical regions where the parasite is endemic. Additional symptoms may include abdominal cramping, bloating, weight loss, nausea, and marked fatigue. Because Cyclospora is not routinely included in all stool ova and parasite examinations or multiplex gastrointestinal PCR panels, clinicians should specifically request testing when clinically indicated. While many immunocompetent patients recover without treatment, illness may persist for weeks or relapse if left untreated. When treatment is warranted, trimethoprim-sulfamethoxazole (TMP-SMX) remains the therapy of choice, with no highly effective alternatives currently available for patients who cannot tolerate sulfonamides.
