[Prolonged diarrhea and weight loss after a biking trip from Tibet to Nepal: infection with Cyclospora].

A 39-year-old man, who had made a cycling tour from Tibet to Nepal, visited the outpatients' clinic one month later because of prolonged diarrhoea, abdominal complaints and serious weight loss. Parasitological examination of the stool revealed oocysts of Cyclospora cayetanensis and the patient was treated with trimethoprim-sulfamethoxazole (co-trimoxazole) with good result. C. cayetanensis has only recently been discovered as a protozoal cause of diarrhoea. Infections are primarily reported from areas with a low hygienic standard e.g. Central and South America, the Indian subcontinent (Nepal), Indonesia and South-East Asia. Clinical symptoms of infection are diarrhoea (usually watery), abdominal cramps and discomfort. The infection can have a prolonged course. Diagnosis is made by parasitological examination of the stool (one should be cautious not to confuse with cryptosporidia) and treatment with trimethoprim-sulfamethoxazole is effective.