Cyclospora, Cystoisospora, Microsporidia, and Campylobacter Jejuni

DIAGNOSIS

These organisms cause chronic diarrhea. Microsporidia can also cause biliary tree disease in patients with advanced infection.

TREATMENT

• Cyclospora is treated with TMP-SMX, one double-strength (DS) tablet PO bid for 7-10 days. Cystoisospora (formerly Isospora) is treated with TMP-SMX, one DS tablet PO qid for 10 days, followed by chronic suppression with TMP-SMX, one DS tablet PO daily.

• Microsporidia caused by Enterocytozoon bieneusi is treated with optimized ART. For other species, albendazole, 400 mg PO bid can be given. Relapses are common when therapy is stopped.

• Campylobacter jejuni is treated with either azithromycin, 500 mg PO daily, or ciprofloxacin, 500-750 mg PO bid for 5 days.