Giardia intestinalis

 

  • – Organism has trophozoite and cyst form
  • – Giardia can survive in cold water for several weeks
  • – 10-25 cyst ingestion can cause infection
  • – Each cyst produces 2 trophozoites
  • – Trophozoites live in duodenum   Encysts when exposed to alkaline bile →  Excreted through stool →   Feco-oral transmission

 

Pathogenesis:

  • – Trophozoites adhere to duodenum
  • – Causes chronic diarrhoea
  • – Acute diarrhea unusual, it protects acute diarrhea
  • – Pathogenesis depends upon host immune response and organism pathogenesis
  • Mucosal change: Normal to severe villous atrophy

 

Clinical features:

  • – Asymptomatic
  • – Severe chronic diarrhea
  • – Malabsorption
  • – Abdominal pain
  • – Bloating
  • – Gas
  • – Weight loss
  • ** Symptoms spontaneously resolves in 50% patients after 7-8 days
  • ** Children <2 year, hypo gammaglobulinemia are more likely to develop serious disease

Diagnosis:

  • – Concentrated, iodine-stained, wet stool preparation, modified trichrome stained permanent smear detects the parasite
  • – Duodenal aspirate, string test
  • – Antibody test in serum- ELISA

Treatment:

  • – Metronidazole 250 mg TDS for 5 days

Copyrights © 2021 Arefin | Gastroenterology | Developed by Chumbok IT