Cyclosporiasis is endemic in Haiti, Nepal, and Peru, with a strong seasonal predominance during rainy spring or summer months. Cases also have been reported in travelers returning from Mexico, Southeast Asia, Puerto Rico, Indonesia, Morocco, Pakistan, and India. Mortality is exceptionally rare. Very little morbidity results from this infection, except in persons with underlying immunosuppression, in whom chronic diarrhea can develop. No racial predilection exists.
Diarrhea is the hallmark of infection.
Onset is abrupt, 1-14 days after exposure to a contaminated source. The diarrhea is described as profuse, malodorous, and watery and can cause dehydration and weight loss. These symptoms are indistinguishable from those of Isospora and Cryptosporidium infections. Recently, biliary disease with right upper-quadrant pain, increased alkaline phosphatase, and thickened gallbladder on ultrasound has been reported in an immunocompromised host infected with Cyclospora . In an immunocompetent host, diarrhea can persist for 7 days to several weeks with a waxing and waning course.