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Cryptosporidiosis

C. parvum, C. hominis

Diagnosis and treatment

Diagnosis:
immunofluorescence, acid fast stain, cryptosporidium antigen or PCR detection on stools or tissues in persons with chronic diarrhea, mostly with CD4 count < 100 cells/μL. If the diarrhea lasts > 4 weeks, the diagnosis of cryptosporidiosis is an AIDS defining illness

Notes on treatment:
mainstay of therapy is the initiation of ART to restore immune competence with CD4 count > 100 cells/μL Additional measures are symptomatic treatment, rehydration and electrolyte management.
The following antiprotozoal therapies can be used additively to ART in severe cases, but are not sufficient to achieve protozoal eradication without immune reconstitution

Drug / Dose Comments
nitazoxanide 
500-1000 mg bid po
14 days
OR
paromomycin
500 mg qid po
14-21 days