Winter diarrhoea

The MicroGnome has fielded quite a few calls on the management of acute infective diarrhoea recently.

Cyclospora oocyst, courtesy CDC

 

Being the right time of year, a number of these will be due to norovirus but some have been travel-associated and caused by a protozoan parasite called Cyclospora. These patients may benefit from a course of co-trimoxazole therapy.

It is interesting to note that many of these patients, particularly those with more prolonged diarrhoea, have symptoms consistent with post-infectious lactose intolerance (PILI). They may thus benefit from dietary lactose exclusion for a short period.

Review of the professional literature shows remarkably little hard data on the subject, particularly regarding PILI in adults.

Cyclospora oocyst stained by acid-fast method, courtesy CDC.

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