Giardiasis
Giardiasis
Acute:
- Self-limiting infection
- Acute watery diarrhea
- Abdominal cramps
- Bloating
- Flatulence
- Stool is profuse & watery in earlier disease
- Frothy
- Voluminous, foul-smelling & greasy(steatorrhoea) later
Chronic
- Chronic diarrhea with malabsorption syndrome
- Steatorrhoea
Chronic Recuurent intestinal giardiasis/Intractable diarrhea
- Common variable deficiency is associated with it.
- They have normal no. of B lymphocytes but these B lymphocytes fail to mature into plasma cells.
- This results in hypogammaglobulinemia
- With reduction in all classes of immunoglobulins
- But sometimes only IgG is reduced.
- Traveler’s diarrhea
Laboratory Diagnosis
Samples
- Stool
- Duodenal contents – Duodenal fluid( Entero test )
- Duodenal/ jejunal biopsy Entero test
Microscopy
- The gold – standard for diagnosis of giardiasis is:
- Microscopic demonstration of the trophozoite, cyst or both in faeces.
- Direct Wet Mount
- Trophozoite with falling leaf motility in saline mount
- Cyst in iodine mount
Sting Test
- Done if microscopy negative
- Sallowing a weighted piece of string until it reaches the duodenum
- Trophozoites adhere to the string and can be visualized after withdrawal of the string.
Serodiagnosis
- ELISA
- Epidemiological purpose Molecular diagnosis
- DNA probes & PCR
- Research purposes
Prevention
- Avoid food & water that might be contaminated
- Filtration of water (be sure filter is fine enough to trap the cysts)
- Boiling water – addition of a tincture of iodine are effective in killing cysts
Treatment
Nitroimidazole derivatives –
- Metronidazole
- Tinidazole drugs of choice
- Acridine dye
- Quinacrine
- Nitrofurans
- Furazolidone
Milk
- Human milk is protective against Giardiasis
- Bile salt stimulated lipases kill amoeba and Giardia.
Exam Question
Giardiasis
Acute:
- Self-limiting infection
- Acute watery diarrhea
- Abdominal cramps
- Bloating
- Flatulence
- Stool is profuse & watery in earlier disease
- Frothy
- Voluminous, foul-smelling & greasy(steatorrhoea) later
Chronic
- Chronic diarrhea with malabsorption syndrome
- Steatorrhoea
Chronic Recurrent intestinal giardiasis/Intractable diarrhea
- Common variable deficiency is associated with it.
- Hypogammaglobulinemia
- Reduction in all classes of immunoglobulins
- But sometimes only IgG is reduced.
- Traveller’s diarrhea
- Laboratory Diagnosis
Microscopy
- The gold – standard for diagnosis of giardiasis is:
- Microscopic demonstration of the trophozoite, cyst or both in faeces.
- Direct Wet Mount
- Trophozoite with falling leaf motility in saline mount
Sting Test
Treatment
Nitroimidazole derivatives –
- Metronidazole
- Tinidazole drugs of choice
Milk
- Human milk is protective against Giardiasis
- Bile salt stimulated lipases kill amoeba and Giardia.
Don’t Forget to Solve all the previous Year Question asked on Giardiasis
