COCCIDIAN CYANOBACTERIUM-LIKE BODY ASSOCIATED DIARRHEA IN AN AUSTRALIAN TRAVELER RETURNING FROM OVERSEAS/

Coccidian/cyanobacterium-like body (CLB) associated diarrhea occurred in a 42 yr old Australian woman returning from Ball, Indonesia. The pa tient had a diarrheal illness of 10 days duration with symptoms of exp losive diarrhea, nausea, anorexia and fever. Fecal examination reveale d CLBs which were detected in modified Ziehl-Neelsen stained fecal sme ars. No other bacterial or parasite pathogens were found. CLBs were va riably acid fast, showed an intense blue auto-fluorescence under UV mi croscopy and appeared as non-refractile hyaline spheres in direct wet mounts, being 8-9 um in diameter. The taxonomic status of CLBs has bee n unclear but recent evidence supports that they are a coccidian paras ite of the genus Cyclospora, rather than cyanobacterium. There is no s pecific therapy for CLB enteritis and spontaneous recovery occurs afte r what may be a prolonged diarrheal illness. CLBs may be a previously unrecognized enteric pathogen although their role in the pathology of diarrheal illness is still undetermined. There is consistency in the c linical and laboratory findings amongst the reported cases and CLBs sh ould be considered in persons with unexplained gastroenteritis, especi ally travellers returning from tropical regions.