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

Infection of the small intestine of humans with the parasitic protozoon Giardia lamblia may have an asymptomatic course, or it may produce acute or chronic diarrhoea. In order to establish if the different clinical outcome of giardiasis in children could be due, at least partially, to strain differences, 19 isolates from asymptomatic and symptomatic cases studied in Mexico City were cultured under axenic conditions and the isoenzyme electrophoretic patterns of 10 different enzymes were compared. Strains from carriers and from symptomatic cases of giardiasis were equally amenable to isolation and axenization. Isoenzyme electrophoresis demonstrated remarkable homogeneity in 7 enzyme patterns for all 19 isolates, except for phosphoglucomutase, for which 3 different zymodemes were found. Therefore, these isolates of G. lamblia, obtained from a single geographical location, tended to be genetically homogeneous. In addition, there were no consistent zymodeme differences between isolates from symptomatic and asymptomatic human infections.
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PMID:Giardia lamblia: isoenzyme analysis of 19 axenic strains isolated from symptomatic and asymptomatic patients in Mexico. 253 17

The availability of new biotechnologies has led to the prediction that new or improved vaccines can be developed for 27 diseases within the next decade. The reasons why such optimism cannot be extended to the availability of vaccines for many other infectious diseases are considered by reviewing the steps in vaccine development, from identification of the etiologic agent to construction of attenuated or inactivated vaccines. Impediments to development may exist or arise at any point in this pathway (e.g., multiplicity of serotypes, inability to cultivate the pathogen, multistage life cycles with multiple antigens, unpredictability of epidemics, inadequate knowledge of pathogenesis and immunity, fear of gene splicing, need for an adjuvant, and lack of profitability). Diseases for which vaccines are not likely to be available in the next decade include trachoma, onchocerciasis, pneumonia due to Legionella and to mycoplasmas, amebiasis and giardiasis, schistosomiasis, syphilis, chlamydial urethritis, trypanosomiasis, leishmaniasis, and filariasis, and non-A, non-B hepatitis.
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PMID:Impediments to the development of additional vaccines: vaccines against important diseases that will not be available in the next decade. 266 4

Once Giardia cysts leave the host, they die quickly if dehydrated but can survive for two months in water as cold as 8 degrees C (46 degrees F). Thus, giardiasis is transmitted through ingestion of infected feces or water. Infection most often causes diarrhea, but if a subacute or chronic form develops, additional signs and symptoms of intestinal distress may be present. Diagnosis is made by finding cysts in a stool sample and/or trophozoites in duodenal fluid. In rare cases, small-bowel biopsy may be necessary. Whether to treat asymptomatic giardiasis is debatable. Drug treatment spares the patient unpleasant symptoms that may develop and eliminates transmission, but available drugs can have side effects and none has been proven safe for pregnant women. By far, the best approach to giardiasis is prevention through education of travelers, nature lovers, and workers in day-care centers and institutions that house the incontinent.
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PMID:Giardiasis. A crimp in the life-style of campers, travelers, and others. 335 71

In the fall of 1985, an outbreak of giardiasis occurred among several swimming groups at an indoor pool in northeast New Jersey. Nine clinical cases were identified, eight of whom had Giardia positive stool specimens. All were female; seven were adults (greater than 18 years) and two were children. The attack rate was highest (39 per cent, 5/13) for the ladies lap group who had exposure on one day. These cases had no direct contact with children or other risk factors for acquiring Giardia. Infection most likely occurred following the ingestion of swimming pool water contaminated with Giardia cysts. The source of Giardia contamination was a handicapped child who had a fecal accident in the pool. He was a member of a group that swam at the same time as the ladies lap group. A stool survey of the handicapped group showed that of the 20 persons tested, nine were positive for Giardia, including the specimen from this child. Examination of the pool records showed that no chlorine levels had been taken on the day of the fecal accident and that on the following day the chlorine level was zero. This is the second report of Giardia transmission among swimming pool attendees. It emphasizes the need to maintain appropriate chlorine levels in swimming pools and to institute measures to clear pools after a fecal accident.
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PMID:Giardia transmission in a swimming pool. 336 96

An outbreak of giardiasis was investigated in one urban day care center; another day care center was selected as a control. In the study day care center, 35 per cent of the children were infected. Infection was spread to at least one household contact of 47 per cent of the infected children. The data suggest person-to-person transmission of giardiasis and the need for measures to prevent its dissemination. Early recognition and treatment of Giardia lamblia infections in children may be indicated.
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PMID:Transmission of Giardia lamblia from a day care center to the community. 374 Mar 41

Tinidazole is a 5-nitroimidazole with selective activity against anaerobic bacteria and protozoa. It is bactericidal at low concentrations and its spectrum covers most anaerobic bacteria and some capnophilic microorganisms. Anaerobic bacteria known to be resistant to tinidazole include anaerobic streptococci, actinomyces and propionibacteria. Tinidazole is one of the most active antibacterial agents against Bacteroides fragilis which is one of the most resistant species of anaerobic bacteria. Only a few strains have been reported to be resistant. Tinidazole has been shown to be efficacious in protozoal infections such as trichomonal vaginitis, amoebiasis and giardiasis. Clinical studies have also shown that tinidazole is efficacious in the treatment of anaerobic infections including respiratory tract infections, intra-abdominal sepsis and obstetrical and gynecological infections. Since tinidazole has no activity against aerobic bacteria, it must be combined with other antibacterial agents in the treatment of mixed infections involving aerobic and anaerobic bacteria. Tinidazole has also been used successfully alone or in combination with other antimicrobial agents for prophylaxis in patients undergoing elective colonic and abdominal surgery, emergency appendectomy and gynecological surgery.
Infection
PMID:Tinidazole--microbiology, pharmacology and efficacy in anaerobic infections. 634 Dec 53

In 1981, 900 children (aged 3 months to 10 years) and 146 staff attending 22 day-care centres in metropolitan Toronto chosen at random provided a stool specimen in a survey for intestinal parasites. Of the children, 4% to 36% were infected in 20 of 22 centres. Overall, 19% of the children and 14% of the staff had intestinal parasites: 8.6% and 4.0% respectively had Dientamoeba fragilis, and 7.8% and 2.0% respectively had Giardia lamblia. The highest prevalence of dientamebiasis was in the 7- to 10-year-olds, whereas giardiasis was detected most frequently in the 6-year-olds. Infection with intestinal parasites was not correlated with age, sex, duration in the day-care centre, dog ownership, travel history, gastrointestinal symptoms or the proportion of children in the day-care centre who were born in less developed countries. Immigrant children and children of parents born in industrialized countries (including Canada) were more likely to be infected than were children born in Canada of parents from the developing world. Dientamebiasis was associated with cat ownership. Thus, intestinal protozoa--in particular, D. fragilis and G. lamblia--are endemic in Toronto day-care centres.
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PMID:Intestinal parasites in metropolitan Toronto day-care centres. 647 61

Giardia lamblia infection in an endemic area was investigated by following a cohort of 33 lactating mothers and their infants in a semiurban community of Bangladesh for one year. Eighty-two percent of mothers and 42% of infants excreted Giardia at least once during the study period. Infants became infected as early as 3 months of age, and 86% of the infected infants had diarrhea, suggesting that the first exposure to the parasite results in disease. Only one of the infected mothers had diarrhea, indicating that with repeated exposure to Giardia, mothers in an endemic area may develop partial immunity that protects against disease but not infection. An interrelationship between maternal and infant colonization was not found. Local and systemic immune responses to Giardia correlated poorly with infection, but milk antibodies were a better reflection of infection than serum antibodies were. Infection with G. lamblia was significantly lower in infants younger than 6 months (9%), an age when many are totally breast-fed. However, we were unable to establish clear-cut protection related to human milk antibodies, and suggest that the lower infection rate in younger infants results mainly from decreased exposure to Giardia cysts.
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PMID:Giardia lamblia infections in a cohort of Bangladeshi mothers and infants followed for one year. 664 42

Giardia lamblia is the first protozoan to be identified and recognized as an important pathogen in human disease. We studied 8 pediatric patients with giardiasis in order to examine the clinical spectrum, the structural changes of the small intestinal mucosa and mainly the protozoan's ultrastructural features. The most common clinical manifestations were diarrhea, abdominal pain, anorexia, vomiting, failure to thrive. Infection was confirmed by excreted cysts in the stools in one patient, by the presence of trophozoites in duodenal aspirate and on jejunal mucosa. Giardiasis was not associated with hypogammaglobulinemia in our patients and no or only slight mucosal abnormalities were present in jejunal biopsies, except one which showed a flat mucosa. Specimens for transmissions and scanning electron microscopy were taken. We could establish the protozoan's features, its normal distribution, its relationship to intestinal mucosa and structural indications of the normal reaction of intestine with the use of ultrastructural techniques. The trophozoites colonized the proximal intestine, adhered to microvilli of columnar cells near the bases of villi, wedged or lodged in mucus. The sticky mucus producing an effective diffusion barrier to nutrients could explain malabsorption phenomena. Numerous intraluminal lymphocytes were seen, suggesting an immune response. These observations indicate that in giardiasis the clinical spectrum and structural changes of the small intestinal mucosa vary widely, suggesting a different reaction of immune system and/or a different degree of infection.
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PMID:[Giardiasis in children. Ultrastructural study of the parasite]. 664 80

Certain enteric ailments are particularly common among homosexual men. They are primarily infectious diseases and include not only such common venereal diseases as gonorrhea and syphilis but also infections not usually regarded as being sexually transmitted. Among the latter are shigellosis, salmonellosis, giardiasis, and amebiasis. Patients' symptoms are non-specific and seldom helpful in diagnosing particular diseases. The practitioner must be prepared to identify a number of infections with similar presentations that may occur singly or together in gay men. Gonorrhea is probably the most common bacterial infection in gay men. Carriage rates as high as 50% have been reported, and extra-genital carriage is common; this necessitates culturing the urethra, rectum, and pharynx. Procaine penicillin G is the treatment of choice for most patients; spectinomycin is probably the drug of choice in penicillin-sensitive patients. In contrast to other venereal diseases, syphilis may have a characteristic protoscopic presentation. Benzathine penicillin G is the treatment of choice for most patients. Lymphogranuloma venereum causes penile lesions and inguinal lymphadenitis in heterosexual men, whereas homosexual men are more prone to proctitis. The disease may mimic Crohn's disease. Recommended treatment includes tetracycline or sulfamethoxazole-trimethoprim. Shigellosis usually presents as an acute diarrheal illness. Patients generally require only supportive treatment with fluids. Herpes simplex viral infection is difficult to diagnose and has several different presentations, including lumbosacral radiculomyelopathy. Symptomatic treatment with sitz baths, anesthetic ointment, and analgesics is recommended. Venereal warts are believed to be caused by the same virus that causes verrucous warts; they are usually found in the anal canal or around the anal orifice. They are commonly treated with 25% podophyllin solution. Parasitic infections include giardiasis, amebiasis, and pinworm infections. Metronidazole may be used in the treatment of symptomatic giardiasis and amebiasis, but it is not approved for the former indication; quinacrine is approved for giardiasis. Pinworm infestation may be treated with pyrantel pamoate or mebendazole. Cure of enteric diseases in homosexual men must be documented.
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PMID:Enteric diseases of homosexual men. 676 90


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