Cryptosporidiosis: symptoms

The main symptoms of cryptosporidiosis are diarrheal syndrome, which proceeds according to the type of acute enteritis or gastroenteritis and develops 2-14 days after infection. During 7-10 (from 2 to 26) days in patients without immunodeficiency there is an abundant watery (cholera-like) stool with a very unpleasant odor, with an average frequency of up to 20 times a day. The patient loses from 1 to 15-17 liters of fluid per day. Profuse diarrhea is accompanied by moderate spastic pain in the abdomen, nausea and vomiting (50%), a slight increase in body temperature (no higher than 38 ° C in 30-60% of patients during epidemic outbreaks), lack of appetite, headache. Usually recovery occurs, but in weakened children the disease can last more than 3 weeks and end with a fatal outcome. Very rarely the disease acquires the character of colitis with the appearance of blood and mucus in the feces.

In people with various immunity disorders, especially in AIDS patients, cryptosporidiosis is chronic (up to several months if the patient does not die earlier) and is accompanied by a sharp weight loss (Slim syndrome). Numerous cases of chronic course of the disease lasting up to 6-11 months have been described, which sometimes occurred with periods of improvement against the background of the use of various pathogenetic agents (reduction in the frequency of stool from 15-20 to 3-5 times a day), but with considerable weight loss, syndrome and death. In some AIDS patients, the stool frequency reached 90 times a day.

15% of patients note the following symptoms of cryptosporidiosis: abdominal pain with localization in the right upper quadrant, nausea, vomiting; jaundice is possible, which often corresponds to cholecystitis. When ultrasound is detected, the increase and dilatation of the gallbladder, the thickening of its walls, changes in the bile ducts. Sometimes, in acute cholecystitis, cholecystectomy is performed, while in some patients, stenosis of the common bile duct is detected, as well as edematous "sticking out" of the nipple, the extension of the common bile duct.

With hepatitis and sclerosing cholangitis, fever, nausea, vomiting, pain in the right upper quadrant develop. In this case, diarrhea may be absent. Increase the level of bilirubin, the activity of alkaline phosphatase and transferases. The pancreas is rarely affected.

With lung lesions, most often combined with intestinal lesions, typical symptoms of cryptosporidiosis may be absent, but only cough, difficulty breathing, shortness of breath, possible hoarseness of voice. When a biopsy of the lung or autopsy occurs on the surface of the epithelium of sclerosed bronchioles, clusters of cryptosporidia are found.

Possible reactive polyarthritis with knee, elbow, wrist and ankle injuries.

For diagnostics in water outbreaks, epidemiological history is of great importance; for sporadic cases - indication of patients belonging to risk groups, the presence of immunodeficiency.

The defeat of the abdominal cavity in cryptosporidiosis can be detected on the roentgenogram. When examining the stomach, the deformation of the walls and the thickening of the folds of the mucous membrane are seen. When the duodenum and small intestine are affected, spastic contractions of the intestinal wall, pronounced enlargement of the lumen, atrophy of the villi of the mucosa, hypersecretion and thickening of the folds are visible.

[1], [2], [3], [4], [5]