Light and electron microscopic identification of Cyclospora species in the small intestine. Evidence of the presence of asexual life cycle in human host.

This is the first case of cyclosporiasis in which the parasite was clearly demonstrated in a duodenal biopsy by light microscopy. Electron microscopy identified the stages of sporozoite, trophozoite, schizont, and merozoite. Although only asexual forms were identified in our case, the sexual cycle must have taken place in the human host, because oocysts were detected in stools of the patients. Therefore, it appears that Cyclospora species require only a single host to complete its entire life cycle. Despite the heavy infection, only enterocytes were invaded. The lamina propria and submucosa were not involved. The morphology of Cyclospora in the intestine is similar to that of Isospora, but differs from that of Cryptosporidium. The morphology of the oocyst of Cyclospora resembles that of Cryptosporidium, but differs from that of Isospora. Thus, a combined study of both stool and intestinal biopsy should readily distinguish Cyclospora from Cryptosporidium and Isospora.