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Query: UMLS:C0017536 (giardiasis)
 1,714 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study is a mapping of intestinal protozoal and pathogenic bacterial infections, and sexually transmitted urethral and anorectal infections among 365 consecutive male patients attending a veneric disease (VD) clinic in Copenhagen. The profile of diseases was strongly correlated to sexual life-style. Amoebiasis and giardiasis were found respectively in 31.9% and 13.8% of homosexuals. None of the heterosexuals had pathogenic protozoa. Protozoal infections were correlated to anilingus. Forty-five percent of the patients were infected in Denmark. Travelling to endemic areas was of no obvious importance. Among males with homosexual partners, 14% had rectal infections. Gonococcal and chlamydial infections were equally frequent. Three percent had symptomatic anorectal herpes simplex infection and 11% anal warts. Gastrointestinal symptoms were not reliable indicators of gastrointestinal infection; symptoms were claimed frequently among homosexuals without infections compared to heterosexuals. Urethral gonorrhoea and/or chlamydia infections were diagnosed in 39% of the heterosexuals compared to only 10% of the homo-bisexuals. Twelve percent of the homosexuals had untreated early syphilis, whereas syphilis was exceptional among heterosexuals. The total burden of infections expressed as the actual number of infections was largest among homosexuals, 40.4%, 22.4%, and 5.3% having one, two, and three infections respectively.
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PMID:Sexually transmitted diseases in hetero-, homo- and bisexual males in Copenhagen. 316 56

Metronidazole, a nitroimidazole derivative, is a unique antimicrobial agent that is active against both bacterial and parasitic organisms, although only the anaerobic members of these groups are susceptible. It has been used for the treatment of trichomoniasis for almost 30 years and is also effective in amebiasis and giardiasis. More recently, metronidazole has emerged as a principal agent for the treatment of anaerobic infections. It is highly effective against all species of anaerobes except certain non-spore-forming gram-positive bacilli and cocci and is the only agent rapidly bactericidal against the Bacteroides fragilis group. The hydroxy metabolite is 65% as effective as metronidazole and may play a major therapeutic role. Clinical studies have substantiated its efficacy for prophylaxis during elective colorectal surgical procedures and the treatment of deep abdominal sepsis (usually in combination with another agent such as an aminoglycoside). Metronidazole is the treatment of choice for bacterial vaginosis and seems to be as effective as vancomycin for treatment of Clostridium difficile-related diarrhea and colitis. Good blood levels are produced after both oral and intravenous administration, and side effects are infrequent and minimal. Metronidazole should not be taken during the first trimester of pregnancy because of concerns about mutagenicity. Tinidazole and ornidazole are recently developed nitroimidazole derivatives that have even greater antimicrobial activity than metronidazole.
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PMID:Symposium on antimicrobial agents. Metronidazole. 331 51

A retrospective survey, which is based on interviews conducted between 1975 and 1984 with 20,000 European tourists returning from 15 destinations in various climatic zones, demonstrates that travelers' diarrhea is the most frequent health problem encountered by travelers in the tropics. The incidence varied from 4% to 51%, depending on the destination. High-risk groups were persons younger than 30 years, adventurous travelers, and travelers with preexisting gastrointestinal illnesses. Illness acquired at various geographic regions showed only minor differences in chronology and symptomatology. The clinical course of travelers' diarrhea was usually short and mild. Additionally, by longitudinal and retrospective analyses, the incidence and prognosis of gastrointestinal infections of greater severity that were acquired after a short stay in a developing country, such as giardiasis, amebiasis, typhoid fever, and cholera, were evaluated; typhoid fever and cholera, in particular, were found to be quite rare.
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PMID:Epidemiologic studies of travelers' diarrhea, severe gastrointestinal infections, and cholera. 352 8

Diarrhoeal disease is a common problem in developing countries. As a result of recent advances in diagnostic methodology, the causative agents can now be identified in most cases of acute diarrhoeal diseases. Enteric bacterial pathogens are the common cause of gastroenteritis in developing countries. Appropriate uses of antibiotics in selected cases of diarrhoea will decrease symptoms or reduce faecal shedding of the organism and prevent spread of infection. Antimicrobial agents improve the diarrhoea associated with cholera, shigellosis, enteric fever, enterotoxigenic Escherichia coli, giardiasis, amoebiasis, and probably Vibrio parahaemolyticus, and enteropathogenic E. coli. Antibiotics have no role in the treatment of viral diarrhoea or uncomplicated salmonella gastroenteritis. Most of the diarrhoeal diseases are self-limited and the wrong choice of antimicrobial agents will worsen the symptoms. Treatment of gastrointestinal infections with antimicrobials will change intestinal microflora, promote the emergence of resistant strains and overgrowth of potential pathogenic bacteria and fungi. Risks and benefits should be considered before prescribing antimicrobial agents.
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PMID:Consequences of treatment of gastrointestinal infections. 354 20

Travelers to developing countries participated in a follow-up study of the health risks associated with short (less than three months) visits to these nations. Travelers to the Greek or Canary Islands served as a control cohort. Participants completed a questionnaire to elicit information regarding pretravel vaccinations, malaria prophylaxis, and health problems during and after their journey. Relevant infections were confirmed by the respondent's personal physician. The questionnaire was completed by 10,524 travelers; the answer rate was 73.8%. After a visit to developing countries, 15% of the travelers reported health problems, 8% consulted a doctor, and 3% were unable to work for an average of 15 days. The incidence of infection per month abroad was as follows: giardiasis, 7/1,000; amebiasis, 4/1,000; hepatitis, 4/1,000; gonorrhea, 3/1,000; and malaria, helminthiases, or syphilis, less than 1/1,000. There were no cases of typhoid fever or cholera.
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PMID:Health problems after travel to developing countries. 359 28

To study the etiology of chronic childhood diarrhea among Nigerian children, 142 patients, aged 6 months to 5 years, with diarrhea for at least 1 month, were evaluated; the study took place during January-December 1983 at the Ahmadu Bello University Teaching Hospital, Zaria, Northern Nigeria. Enteropathogenic agents were identified in stools of 90 (63%) patients. Giardia lamblia and Entamoeba histolytica were most commonly detected, representing 41% and 23%, respectively, of all parasitic pathogens. In children with negative stool microscopy, chronic diarrhea was associated with primary lactose intolerance (2 cases), abdominal tuberculosis (2 cases), hyponatremia, low serum albumin, anemia due to sickle cell disease, or Staphylococcus aureus infection. In contrast with chronic diarrhea etiologies reported among children in Europe and North America, infections were the major cause of chronic childhood diarrhea among these children. In general, it is accepted that intestinal infection usually produces acute diarrhea--and that, if the host fails to mount a competent immune response, if there is repeated exposure to infectious agents, or if severe infection damages a substantial proportion of absorptive cells, then severe, protracted diarrhea may result. The high case fatality rate of 9% in this series was associated with specific infectious complications of septicemia, bronchopneumonia, lobar pneumonia and measles. Severe malnutrition also worsened the prognosis in chronic diarrhea. The results indicate that early detection and treatment of amebiasis and giardiasis is a useful approach in the treatment of chronic diarrhea cases among children.
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PMID:Chronic diarrhoea in Nigerian children. 383 11

Homosexual men are at increased risk for traditional sexually transmitted anorectal infections (gonorrhea, syphilis, venereal warts, herpes and chlamydial infection) and enteric infections characterized by a low infecting inoculum (hepatitis A and B, amebiasis, giardiasis, shigellosis and campylobacteriosis). Infections account for most of the gastrointestinal symptoms in homosexual men seen at sexually transmitted disease clinics, but asymptomatic and polymicrobial infections are also common. Distinguishing three syndromes-proctitis, proctocolitis and enteritis-is clinically useful because these syndromes correlate with specific microorganisms and modes of transmission. A careful anoscopic examination, rectal Gram's stain, cultures for gonorrhea and chlamydia, VDRL and darkfield examination of suspicious lesions should be routinely done when sexually active homosexual men present with unexplained gastrointestinal symptoms. Based on the history, physical examination and initial laboratory studies, patients can usually be classified as having proctitis, proctocolitis or enteritis. This distinction facilitates selection of both confirmatory diagnostic tests and antimicrobial therapy. The effectiveness of empiric treatment regimens for asymptomatic sexual contacts or for symptomatic patients in whom microbiological tests are pending has not been studied.
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PMID:Anorectal and enteric infections in homosexual men. 383 33

Fifty-five Thai patients with chronic diarrhoea were prospectively studied to find out the underlying causes. The aetiology was identified in 38.2%, uncertain in 29.1%, and unknown in 32.7% of the patients. In the group with a definitive aetiologic diagnosis, parasitic and infective causes were commoner than non-infective causes. Amoebiasis and giardiasis were more frequent than expected, such that empirical therapeutic trial with an antiprotozoal may be justified if initial routine investigations fail to uncover the cause of the diarrhoea. No significant clinical features were noted between the infective and the non-infective groups. Overall, repeated stool microscopy using the concentration technique was the most useful single investigation in approaching the chronic diarrhoea problem.
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PMID:Chronic diarrhoea: a prospective study in Thai patients at Chulalongkorn University Hospital, Bangkok. 409 10

This paper focuses on the growing incidence of the "new" sexually transmitted parasitic enteric diseases: amebiasis and giardiasis. Two major behavioral factors influence transmission of these diseases in the gay community: 1) oral-rectal and oral-genital sexual contact and 2) multiple sexual partners. Pathogenesis, clinical signs and symptoms and complications associated with these diseases are also discussed. Although many patients present with severe symptoms, approximately 50 percent of infected patients are asymptomatic. The diagnostic procedures include a fresh purged stool examination, nonpurged warm stool examinations, and/or cold stool specimens. The serologic tests (serum precipitin and hemagglutination) are of value only in severely symptomatic invasive disease. Different treatment regimens and their side effects are discussed. Drugs used in the treatment of the enteric diseases include diiodohydroxyquin, metronidazole, furamide, and paromomycin. Only 60 to 70 percent of patients with the disease are cured, and 30 to 40 percent of patients require multiple courses of therapy. Test-of-cure examinations, ideally consisting of one or two purged stool specimens, are necessary in follow-up management.
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PMID:Enteric diseases. 626 Apr 31

As early syphilis becomes more uncommon in the community, it will present frequently to the tertiary hospital as a diagnostic problem. Twenty patients with classic signs and symptoms of primary and secondary syphilis in whom the correct diagnosis was initially missed are presented. The importance of a routine admission Venereal Disease Research Laboratory test (VDRL) in making the correct diagnosis is emphasized. The laboratory techniques for diagnosing syphilis and recommended treatment schedules are presented. Clinical manifestations of herpes progenitalis, problems with pregnancy and association with cervical carcinoma are also presented. Enteric diseases (hepatitis, shigellosis, giardiasis and amebiasis) as sexually transmitted diseases in homosexual men are summarized.
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PMID:Syphilis and other sexually transmitted diseases. 626 Apr 32


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