A 32 years old slum dweller presented with complaints of diarrhea and constipation with a 2 kg weight loss for last 2 months. On examination, the patient had a dry tongue and poor skin turgor. An endoscopic biopsy from the gut revealed the following microscopic appearance. What is the most likely diagnosis?
A. Entamoeba histolYtica
B. Whipple’s disease
D. Helicobacter PYlori
Ans: C. Giardiasis
- History & duodenal biopsy highly suggestive of Giardiasis.
- Biopsy showing characteristic pear shaped structures.
- Identified in duodenal biopsies.
- Characteristic pear shape with two equally sized nuclei.
- Large numbers of trophozoites tightly bound to brush border of villous enterocytes.
- No invasion & normal small intestinal morphology.
- Heavy infections – Villous blunting with increased numbers of intraepithelial lymphocytes & mixed lamina propria inflammatory infiltrates.
- Asymptomatic carriage to fulminunt diarrhea & malabsorption.
- Most infected persons – Asymptomatic.
- Symptoms develop after an incubation period (5-6 days).
- Persists upto 1-3 weeks.
- Prominent early symptoms – Diarrhea, abdominal pain, bloating, belching, flatus, nausea &vomiting.