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Cryptosporidiosis - Symptoms.
Medical expert of the article
Last reviewed: 04.07.2025
The main symptoms of cryptosporidiosis are diarrhea syndrome, which occurs as acute enteritis or gastroenteritis and develops 2-14 days after infection. For 7-10 (from 2 to 26) days, patients without immunodeficiency experience copious watery (cholera-like) stools 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 abdominal pain, nausea and vomiting (50%), a slight increase in body temperature (not higher than 38 ° C in 30-60% of patients during epidemic outbreaks), loss of appetite, headache. Recovery usually occurs, but in weakened children the disease can last more than 3 weeks and end in death. Very rarely, the disease takes on the character of colitis with the appearance of blood and mucus in the stool.
In people with various immune disorders, especially in AIDS patients, cryptosporidiosis becomes 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, sometimes with periods of improvement against the background of the use of various pathogenetic agents (reduction of stool frequency from 15-20 to 3-5 times a day), but with significant weight loss, with the development of slim syndrome and death. In some AIDS patients, the frequency of stool reached 90 times a day.
15% of patients report the following symptoms of cryptosporidiosis: abdominal pain localized in the right upper quadrant, nausea, vomiting; jaundice is possible, which often corresponds to cholecystitis. Ultrasound reveals an enlarged and stretched gallbladder, thickened walls, and changes in the bile ducts. Sometimes, with acute cholecystitis, cholecystectomy is performed, and in some patients, stenosis of the common bile duct is detected, as well as an edematous "protruding" papilla of Vater, stretching of the common bile duct.
With hepatitis and sclerosing cholangitis, fever, nausea, vomiting, and pain in the right hypochondrium develop. Diarrhea may be absent. Bilirubin levels, alkaline phosphatase activity, and transferases increase. The pancreas is rarely affected.
In case of lung damage, most often combined with intestinal damage, typical symptoms of cryptosporidiosis may be absent, and only cough, difficulty breathing, shortness of breath, and possibly hoarseness of the voice may appear. During lung biopsy or autopsy, accumulations of cryptosporidia are found on the surface of the epithelium of sclerotic bronchioles.
Reactive polyarthritis with damage to the knee, elbow, wrist and ankle joints is possible.
For diagnostics of waterborne outbreaks, the epidemiological anamnesis is of great importance; for sporadic cases, indications of the patient's belonging to risk groups and the presence of immunodeficiency.
Damage to the abdominal organs in cryptosporidiosis can be detected on an X-ray. When examining the stomach, deformation of the walls and thickening of the folds of the mucous membrane are visible. When the duodenum and small intestine are affected, spastic contractions of the intestinal wall, a pronounced expansion of the lumen, atrophy of the villi of the mucous membrane, hypersecretion and thickening of the folds are visible.
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