Cyclosporiasis in Pregnancy: A Narrative Review

Abstract

Objective: Cyclosporiasis, caused by the protozoan parasite Cyclospora cayetanensis, is an emerging foodborne illness of increasing clinical relevance in both endemic and developed countries. Its specific implications during pregnancy remain poorly characterized. Our objective is to synthesize current evidence on the clinical presentation, diagnosis, treatment, and prevention of cyclosporiasis during pregnancy. Study Design: This is a narrative review of peer-reviewed literature published between 2012 and 2026, supplemented by guidance from the Centers for Disease Control and Prevention (CDC) and other major health authorities. Results: Cyclosporiasis presents with prolonged watery diarrhea, profound fatigue, and anorexia, all features of heightened concern during pregnancy, given the risks of dehydration, malnutrition, and preterm labor. Trimethoprim-sulfamethoxazole (TMP-SMX) remains the treatment of choice, but its use requires careful consideration of gestational timing, folate supplementation, and the risk of neonatal hyperbilirubinemia. No highly effective alternatives exist for sulfonamide-allergic patients. There is no evidence of vertical transmission. Conclusion: Cyclosporiasis in pregnancy is a clinically challenging condition requiring prompt recognition and tailored management. Prevention through rigorous food and water hygiene is paramount. TMP-SMX can be used safely with appropriate precautions. Further research is needed to define pregnancy-specific outcomes and treatment protocols.