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

A high incidence of diarrhea was reported in a group of approximately 1,400 Americans who traveled to the Portuguese island of Madeira in October 1976. A mail questionnaire survey revealed that 39% of the responding 859 travelers experienced diarrhea; in 42% of these diarrhea lasted for longer than 1 week. The most frequent accompanying symptoms were abdominal cramps (75%), abdominal distention (72%), nausea (70%), and weight loss (40%). Of all travelers surveyed, 33% developed an illness resembling giardiasis with a median incubation period of 4 days. Of 35 ill patients who had a stool culture, enteric pathogens were recovered from 4 (3 Shigella and 1 Salmonella). On the other hand, of 58 ill patients whose stools were examined for parasites, Giardia lamblia was recovered from 27 (47%). Analysis of the epidemiologic data showed that drinking tap-water on the island was significantly associated with illness; eating ice cream or raw vegetables on the island was also implicated. There was no evidence of continuing transmission of giardiasis in American tourists visiting Madeira 8--12 months after the outbreak.
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PMID:Giardiasis in American travelers to Madeira Island, Portugal. 72 17

Giardia lamblia are protozoan parasites which cause human intestinal disease. The life cycle has a multiplying intraduodenal trophozoite and an excreted cyst. Infection occurs after cyst ingestion from faecally contaminated water or by direct faecal-oral transmission in situations of poor sanitary standards, but the zoonotic nature of giardiasis is debated. The pathophysiology may arise from enzyme or active transport deficiencies, synergy with intestinal bacteria or an immunopathological process. Diagnosis is made by microscopic identification of cysts or trophozoites in small bowel samples or faeces. Symptoms are acute with diarrhoea (without blood), abdominal cramps, bloating and flatulence. The treatment of choice is either metronidazole or tinidazole. No vaccine or drug prophylaxis exists, and measures to avoid cyst ingestion should be undertaken.
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PMID:Giardia lamblia as an intestinal pathogen. 159 70

In June 1983, an outbreak of waterborne giardiasis occurred in a group of 93 university students and faculty participating in a geology field course in Colorado. All cases occurred in one subgroup of persons who were heavily exposed to untreated stream water on a field trip, and the risk of illness was strongly related to the amount of untreated stream water consumed. The median incubation period from a brief exposure to the first symptom was 7 days. The authors compared symptoms and stool sample results among 31 Giardia-positive persons in the exposed group and 36 Giardia-negative participants in an unexposed group to assess several case definitions for acute giardiasis. Diarrhea, abdominal cramps, flatulence, foul-smelling stools, nausea, excessive tiredness, bloating, anorexia, and chills were each significantly more common in the first group than in the second. A giardiasis case definition of 5 days or more of diarrhea--the definition used in many epidemiologic studies of giardiasis--had a specificity of 100 percent but a sensitivity of only 32.2 percent compared with a definition based on results of stool examinations. When a case was defined as an illness lasting 7 days or more, with a combination of two or more of six symptoms (diarrhea, flatulence, foul-smelling stools, nausea, abdominal cramps, and excessive tiredness), sensitivity rose to 73 percent, with a specificity of 88 percent. Such a case definition may be an improvement over that of 5 days of diarrhea, especially in outbreaks where there is good laboratory documentation that Giardia is the etiologic agent. The definition should be validated in other outbreaks and in situations where giardiasis must be distinguished from gastrointestinal disease caused by other agents.
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PMID:Acute giardiasis: an improved clinical case definition for epidemiologic studies. 199 3

Eight pediatric patients with presenting symptoms of chronic diarrhea, abdominal cramps, weight loss, and/or recurrent emesis were diagnosed as having giardiasis by duodenal brush cytology. All patients had at least three stool specimens examined for ova and parasites, which failed to reveal Giardia lamblia cysts or trophozoites. In each patient, the small intestinal mucosal biopsies as well failed to reveal giardia. No complications were encountered during any of the procedures. Duodenal brush cytology for giardiasis appears to be a valuable diagnostic adjunct potentially superior to stool examination as well as endoscopic grasp small bowel biopsy.
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PMID:Diagnosis of giardiasis in infants and children by endoscopic brush cytology. 277 64

Giardiasis is the intestinal infection resulting from infestation with the human parasite Giardia intestinalis, also called Giardia lamblia. The infection may be asymptomatic or present with a variety of symptoms such as diarrhoea, weight loss, abdominal cramps, and failure to thrive. Giardiasis is most often diagnosed after recent travel or in day care centres. The organism has two stages in its life cycle. It is usually ingested as a cyst with as few as 10-25 cysts being sufficient to cause infection. After excystation, the organism is a replicative trophozoite which may attach to the small bowel wall. Giardia intestinalis does not invade the bowel wall. Trophozoites may encyst and be shed in faeces for future ingestion by another host. Diagnosis of infection is by stool examination which may also eliminate other possible infectious agents. Small bowel biopsy may be necessary in difficult individual cases or to rule out non-infectious illnesses, and stool ELISA may serve for large population screening examinations. The mainstay of treatment is metronidazole 250-400 mg three times per day by mouth for 5 days.
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PMID:Review article: the management of Giardiasis. 1038 16

A total of 200 cases aged 1-13 years complaining of symptoms suggestive of giardiasis in addition to thirty normal healthy children as a control group was examined clinically and laboratory using stool examination and detection of Giardia coproantigen in faeces by Dot ELISA and direct IFA. Stool examination detected 39 cases (19.5%) while Dot ELISA and direct IFA detected 49 cases (24.5%) with 100% sensitivity and 93.8% specificity. The common clinical findings were diarrhea, abdominal cramps, anorexia, underweight, pallor and manifestations of vitamin deficiency. The results were discussed.
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PMID:Comparative study on ELISA, IFA and direct methods in diagnosis of giardiasis. 1221 16

Giardia lamblia, the cause of human giardiasis, is among the most common intestinal protozoa worldwide. Human infection may range from asymptomatic shedding of giardial cysts to symptomatic giardiasis, being responsible for abdominal cramps, nausea, acute or chronic diarrhoea, with malabsorption and failure of children to thrive. At present, treatment options include the nitroimidazoles derivatives; especially metronidazole, which has been the mainstay of treatment for decades and is still widely used. The increasing number of reports of refractory cases with this group of drugs and other antigiardial agents, has raised concern and led to a search for other compounds, some of which have arisen due to the introduction of drugs initially addressed to other diseases. The present article examines some of the most important points of antigiardial pharmacotherapy available at present and the future prospects of development of new agents.
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PMID:Giardiasis: a pharmacotherapy review. 1769 91

A total of 200 cases aged 10-30 years complaining of symptoms suggestive of giardiasis in addition to thirty cross matched normal individuals as a control group was examined clinically and laboratory using stool examination and detection of Giardia coproantigen in faeces by the Dot-ELISA. Stool examination detected 39 cases (19.5%) while Dot-ELISA detected 49 cases (24.5%) with 100% sensitivity and 93.8% specificity. The common clinical findings were diarrhea, abdominal cramps, anorexia, underweight, pallor and manifestations of vitamin deficiency.
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PMID:Dot-ELISA copro-antigen and direct stool examination in diagnosis of giardiasis patients. 1798 95

Giardiasis is one of the most common intestinal protozoan infections worldwide. The etiological agent, Giardia duodenalis (syn. Giardia lamblia, Giardia intestinalis), is a flagellated, binucleated protozoan parasite which infects a wide array of mammalian hosts (Adam, 2001). The symptoms of giardiasis include abdominal cramps, nausea, and acute or chronic diarrhea, with malabsorption and failure of children to thrive occurring in both sub-clinical and symptomatic disease (Thompson et al., 1993). Infections are transmitted by cysts which are excreted in the feces of infected humans and animals. Human giardiasis is distributed worldwide, with rates of detection between 2-5% in the developed world and 20-30% in the developing nations (Farthing, 1994). There is significant variation in the outcome of Giardia infections. Most infections are self-limiting, although re-infection is common in endemic areas and chronic infections also occur. Moreover, some individuals suffer from severe cramps, nausea and diarrhea while others escape these overt symptoms. This review will describe recent advances in parasite genetics and host immunity that are helping to shed light on this variability.
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PMID:Giardia duodenalis: the double-edged sword of immune responses in giardiasis. 2059 99

Reduced intestinal absorption of levothyroxine (LT4) is the most common cause of failure to achieve an adequate therapeutic target in hypothyroid patients under replacement therapy. We present the case of a 63-year-old woman with autoimmune hypothyroidism previously well-replaced with tablet LT4 who became unexpectedly no more euthyroid. At presentation, the patient reported the onset of acute gastrointestinal symptoms characterized by nausea, loss of appetite, flatulence, abdominal cramps and diarrhea, associated with increase of thyrotropin levels (TSH: 11 mIU/mL). Suspecting a malabsorption disease, a thyroxine solid-to-liquid formulation switch, at the same daily dose, was adopted to reach an optimal therapeutic target despite the gastrointestinal symptoms persistence. Oral LT4 solution normalized thyroid hormones. Further investigations diagnosed giardiasis, and antibiotic therapy was prescribed. This case report is compatible with a malabsorption syndrome caused by an intestinal parasite (Giardia lamblia). The reduced absorption of levothyroxine was resolved by LT4 oral solution. Learning points: The failure to adequately control hypothyroidism with oral levothyroxine is a common clinical problem. Before increasing levothyroxine dose in a patient with hypothyroidism previously well-controlled with LT4 tablets but no more in appropriate therapeutic target, we suggest to investigate non adhesion to LT4 therapy, drug or food interference with levothyroxine absorption, intestinal infection, inflammatory intestinal disease, celiac disease, lactose intolerance, short bowel syndrome after intestinal or bariatric surgery, hepatic cirrhosis and congestive heart failure. LT4 oral solution has a better absorptive profile than the tablet. In hypothyroid patients affected by malabsorption syndrome, switch of replacement therapy from tablet to liquid LT4 should be tested before increasing the dose of LT4.
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PMID:Switch from tablet levothyroxine to oral solution resolved reduced absorption by intestinal parasitosis. 3089 50


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