Reactive arthritis associated with cryptosporidium enteritis.

Hay, E M; Winfield, J; McKendrick, M W

doi:10.1136/bmj.295.6592.248

Cited by 33 publications

(11 citation statements)

References 2 publications

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“…It should also be noted that the cases were negative for Cryptosporidium infection 2 years after the outbreak. Our findings imply that the health consequences of Cryptosporidium infection persist even longer than indicated in previous reports [6, 10], although gastrointestinal symptoms have been described to continue for 24–36 months in up to eight of 53 Cryptosporidium cases in Stockholm [7]. Similar long-term effects following initial infection have also been recorded for other gastrointestinal parasites, e.g.…”

Section: Discussionsupporting

confidence: 86%

Persisting post-infection symptoms 2 years after a large waterborne outbreak of Cryptosporidium hominis in northern Sweden

2018

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ObjectivesIn 2010–2011, a large waterborne outbreak of Cryptosporidium hominis affected the city of Östersund in Sweden. Previous findings had suggested that gastrointestinal symptoms can persist for up to 11 months after the initial infection. Here we investigated whether the parasite could cause sequelae in infected individuals up to 28 months after the outbreak. We compared cases linked to the outbreak and the previous follow-up study with non-cases regarding symptoms present up to 28 months after the initial infection. We investigated whether cases were more likely to report a list of symptoms at follow-up compared to non-cases, calculating odds ratio and 95% confidence interval obtained through logistic regression.ResultsA total of 559 individuals (215 cases) were included in the study. Forty-eight percent of the outbreak cases reported symptoms at follow-up. Compared to non-cases, cases were more likely to report watery diarrhea, diarrhea, abdominal pain, fatigue, nausea, headache, or joint stiffness/pain/discomfort at follow-up after adjusting for age and sex. Our findings suggest that gastrointestinal symptoms and joint pain can persist several years after the initial Cryptosporidium infection and should be regarded as a potential cause of unexplained gastrointestinal symptoms or joint pain in people who have had this infection.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3721-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 86%

Persisting post-infection symptoms 2 years after a large waterborne outbreak of Cryptosporidium hominis in northern Sweden

2018

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“…On study population level the time between initial infection and point of follow-up could vary between 2.5-8.5 months in Östersund, and 2.5-11.5 months in Skellefteå. Our findings suggest that the health consequences may persist even longer than stated in previous reports [ 13 , 15 ] although persisting gastrointestinal symptoms between 24 and 36 months after infection have been described in up to eight of 53 Cryptosporidium cases [ 14 ]. Early childhood Cryptosporidium infection and diarrhea has been linked to impaired physical fitness 4–7 years later [ 19 ].…”

Section: Discussionsupporting

confidence: 55%

“…Similar to other gastrointestinal pathogens, Cryptosporidium infection may also cause reactive arthropathy. Reactive arthropathy after Cryptosporidium infection was first described in case reports in the 80s [ 15 , 16 ]. A more recent prospective epidemiological study suggests presence of joint related symptoms up to three months after the original infection [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Post-infection symptoms following two large waterborne outbreaks of Cryptosporidium hominis in Northern Sweden, 2010–2011

et al. 2015

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BackgroundIn 2010–2011, two large waterborne outbreaks caused by Cryptosporidium hominis affected two cities in Sweden, Östersund and Skellefteå. We investigated potential post-infection health consequences in people who had reported symptoms compatible with cryptosporidiosis during the outbreaks using questionnaires.MethodsWe compared cases linked to these outbreaks with non-cases in terms of symptoms present up to eleven months after the initial infection. We examined if cases were more likely to report a list of symptoms at follow-up than non-cases, calculating odds ratios (OR) and 95 % confidence intervals (CI) obtained through logistic regression.ResultsA total of 872 (310 cases) and 743 (149 cases) individuals responded to the follow-up questionnaires in Östersund and Skellefteå respectively. Outbreak cases were more likely to report diarrhea (Östersund OR: 3.3, CI: 2.0-5.3. Skellefteå OR: 3.6, CI: 2.0-6.6), watery diarrhea (Östersund OR: 3.4, CI: 1.9-6.3. Skellefteå OR: 2.8, CI: 1.5-5.1) abdominal pain (Östersund OR: 2.1, CI: 1.4-3.3, Skellefteå OR: 2.7, CI: 1.5-4.6) and joint pain (Östersund OR: 2.0, CI: 1.2-3.3, Skellefteå OR: 2.0, CI: 1.1-3.6) at follow-up compared to non-cases.ConclusionsOur findings suggest that gastrointestinal- and joint symptoms can persist several months after the initial infection with Cryptosporidium and should be regarded as a potential cause of unexplained symptoms in people who have suffered from the infection.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1871-6) contains supplementary material, which is available to authorized users.

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“…Recently, other clinical profiles nave also received attention. Because diagnostic proficiency varies with laboratory experience and frequency of cryptosporidiosis in a given population, and because Cryptosporidium oocysts are more easily identified in persons with diarrhea than those without, these other clinical presentations may actually be underrecognized: they include acalculous cholecystitis, sclerosing cholangitis, hepatitis, pancreatitis, reactive arthritis and a variety of respiratory symptoms (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). While initial reports of these manifestations were mostly in HIV-infected patients, they are increasingly described in immunologically intact persons as well.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of AIDS-Related Intestinal Parasites

Ungar¹

1990

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Ia. REPORT SECURITY CLASSi F CATION 'b RES-R!C. VE MARKINGS Unclassified 2a. SECURITY CLASSIFICAT:ON AJ7HOR;T'y 3 7"S'~O A'1A LAB.L TY OF REPORT Approved for public release; 2b. DECLASSIFICATION / DOWNGRADING SC4DL di stribut ion unl imitedi 4. PERFORMING ORGANIZATION REPORT \UMBIEER(S(5 MON T0R;NG ORGA%!MZAT ON REPORT NUMBER(S) 6a. NAME OF PERFORMING ORGANIZATION T6b OFP CE SYMBOL 7a NAME OP MON !TOR,\G ORGANIZATION iniformed Services U'niversit%, of~ (if applicable) the Health Sciences 6c. ADDRESS (City, State, and ZIP Code) 7b ADDRESS (City, State, and ZIP Code) 7. Edward Herbert School of Medicine 4301 Jones Bridge Road ethesda, Maryland 20814-4799 8a. NAME OF FUND] G,$PONSORI Nh 8bo OFFCE SYMBOL 9 PROQuREMENT NSTRI-jMENT IDENTIFICATION NUM15ER ORGANIZATON. Army :iedicalI Zesearch & Development Command MIPR 86MM6514 8c. ADDRESS (City, State, and ZIP Code) 10 SOU)RCE OF FUNDING NUMrVBERS

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Reactive arthritis associated with cryptosporidium enteritis.

Cited by 33 publications

References 2 publications

Persisting post-infection symptoms 2 years after a large waterborne outbreak of Cryptosporidium hominis in northern Sweden

Persisting post-infection symptoms 2 years after a large waterborne outbreak of Cryptosporidium hominis in northern Sweden

Post-infection symptoms following two large waterborne outbreaks of Cryptosporidium hominis in Northern Sweden, 2010–2011

Diagnosis of AIDS-Related Intestinal Parasites

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