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

Giardia lamblia has a cosmopolitan distribution. The organism exists in two stages--the trophozoite and the cystic stage. Infected children may have acute or chronic diarrhea, crampy abdominal pain, anorexia, malasorption and poor weight gain and may be misdiagnosed as celiac disease. Infection may be selflimited or chronic even over years. Diagnosis is usually made by finding the characteristic cyst in stool specimens or by duodenal aspiration. Histological sections and impression smears (AMENT) of intestinal mucosa biopsies have been proved to be the most reliable method for detecting giardiasis. Evaluation of impression smears for parasites is easier and quicker than examining serial sections of biopsies. Out of 175 selected patients with intestinal complaints which were undergone small intestinal biopsy 11 were infected with giardia lamblia (6.2%). All infected children were symptomatic, malabsorption could be demonstrated in 5/8, lactase levels were reduced in most children. Examination of duodenal aspirates, stool specimens and histological sections (routine histology) alone would not have been diagnostic in every case. Evaluation of impression smears proved to be a reliable method in detecting giardia lamblia infection and is recommended whenever an intestinal biopsy is performed.
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PMID:[The value of the "impression smear" in detecting giardia lamblia infection (author's transl)]. 64 94

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

Diarrhea affects approximately 330,000 travelers from industrialized nations each year. Diarrhea is a reflection of inadequate hygiene or waste disposal in the countries visited, usually developing countries. The greatest incidence occurs in 20-29 years olds who take the most dietary risks. Some foods that pose the greatest risk in descending order include raw oysters, steak tartare, ice cubes, washed vegetables, cold milk, puddings, and sandwiches with mixed fillings. 40% of all travelers have a self limiting and rarely grave diarrheal illness caused by local enterotoxigenic Escherichia coli (ETEC). Following an incubation period of 5-9 days, symptoms appear (cramps, fever, and 10 or more diarrheal episodes/day). 5% are infected with Giardia lamblia and 4% with Entamoeba histolytica. Giardiasis occurs worldwide and is characterized by grumbling diarrhea, cramps, and flatulence. E. histolytica causes a severe illness characterized by colitis with bloody stools, anorexia, malaise, sweats, weight loss, and epigastric pain. Only 10-100 Shigella bacteria are required by cause shigellosis. Symptoms include blood and mucus in the diarrhea and malaise. A traveler who ingests food with 100,000 Salmonella bacteria in it most likely will fall ill 48 hours after eating the contaminated food. Typhoid and paratyphoid fevers have an incubation period of about 12 days and may be fatal. Initial symptoms consists of headache, malaise, fever, and pain and 2 weeks later bloody diarrhea appears. Additional common diarrheal illnesses include cholera, post infectious tropical malabsorption, and those caused by Vibrio parahaemolyticus and Campylobacter species. Another disease common in areas of poor hygiene is poliomyelitis with fever, sore throat, and headache present in mild forms. If the virus invades the central nervous system, however, paralysis occurs.
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PMID:Exotic diarrhoeal problems and poliomyelitis. 259 59

A total of 1,167 stool specimens collected from 0.6-6 years old patients attending King Abdel Aziz University Hospital (KAUH) in Riyadh, were examined for intestinal parasites. Of these 243 (20.8%) were positive. Giardia lamblia (13.5) and Enterobius vermicularis (4.2%), were the commonest parasites found. Other parasites present include Ascaris lumbricoides, Entamoeba histolytica and Hymenolepis nana. Abdominal pain (38.6%) and diarrhoea (27.6%) were the most common causes of referral presented among both males and females examined groups. Out of 211 patients positive for different parasites and showing different causes of referral, 45.5% were accompanied with abdominal pain and 22.3% having pruritus ani, while the percentage of patients having diarrhoea and positive for different parasites (9.5%) are less. It has been concluded that diarrhoea is not a major sign of parasitic infestation in 0.6-6 years old age group. Other causes of referral include, loss of appetite, underweight and failure to thrive which are mainly associated with Giardia lamblia infection.
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PMID:Pattern of intestinal parasitic infection in preschool children in Riyadh, Saudi Arabia. 280 81

Although Giardia lamblia cysts are an important contaminant of surface water supplies, only one swimming pool outbreak, involving an infant and toddler swim class, has been reported. We describe an outbreak of giardiasis associated with a hotel's new water slide pool which was cleansed by both bromination and sand filtration. Among the 107 hotel guests and their visitors surveyed, 29 probable and 30 laboratory-confirmed cases of Giardia infection were found. Cases ranged from 3 to 58 years of age, with a mean age of 21 years. The 5-year modal age grouping was 5 to 10 years of age. Symptoms in the 59 cases included: diarrhea (48), cramps (38), foul smelling stools (29), loss of appetite (23), fatigue (20), vomiting (18), greasy stools (15), fever (11) and weight loss (10). Four children and 2 adults were hospitalized. Significant associations were found for staying at the hotel, using the water slide pool and swallowing pool water. A possible contributing factor was the emptying of an adjacent toddlers' wading pool, a potential source of fecal material, into the water slide pool. Transmission of Giardia can occur in water slide pools and therefore should be considered in cases of protracted diarrhea among users of such pools.
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PMID:Giardiasis associated with the use of a water slide. 334 75

1422 faecal samples sent by general practitioners for routine parasitological examination were surveyed in 3 months. Of the 10.8% short-listed for special examination for cryptosporidium oocysts, 14 (9.1%) were positive. Charcot-Leyden crystals were not associated with cryptosporidiosis. All 14 patients had symptoms of gastrointestinal infection, which seemed to be related to a trip abroad. The incubation period varied between 4 and 12 days. Clinically cryptosporidiosis could not be distinguished from giardiasis, but its duration was shorter (median 10 days), strong abdominal pain and cramps were commoner, and bloating, anorexia, and weakness were less common. The disease can be diagnosed by identification of oocysts in faecal samples that have undergone formalin-ether concentration. There is no specific treatment for it, and recovery is spontaneous.
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PMID:Cryptosporidium: a frequent finding in patients with gastrointestinal symptoms. 613 70

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

An eight-month survey of patients with gastrointestinal complaints is presented. There were 213 cases collected. Based on stool examinations, Ascaris lumbricoides is still the most common followed by Giardia lamblia and Trichuris trichiura, respectively. From these 213 cases, Giardia was detected in 34 patients. Most of the subjects belong to the older age group between 7-10 years. Anorexia and weight loss are the most common complaints followed by diarrhoea. Based on the duration of complaints, giardiasis is a chronic infection. All 34 subjects were managed with metronidazole at a dose of 40 mg per kg per day in three divided doses for a period of seven days. Cure rate was 100% with no toxicity noted. Metronidazole is therefore suggested as a drug of choice for Giardia lamblia infection.
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PMID:The efficacy of metronidazole in the treatment of giardiasis. 716 51

This report describes eight cases of proventriculitis and ventriculitis in ostrich chicks less than 2 months old. Clinical signs included acute onset of lethargy and anorexia in three cases, and chronic weight loss with lethargy and anorexia in four cases; no history was available in one case. There was limited antibiotic therapy in two cases; a third case was treated for giardiasis. Concurrent bacterial, yeast, and viral infections were common. Lymphoid depletion and/or necrosis of bursa, thymus, and spleen suggested severe immune challenge or immunosuppression in many cases. Histologically, there was severe ulcerative proventriculitis and ventriculitis with intralesional fungal hyphae. In two chicks with granulomatous pneumonia, similar fungal hyphae were also observed in the lung. Fungal hyphae were rarely septate, with irregular, non-parallel walls, and ranged in diameter from 7 to 20 microns. Occasional globoid distentions of the hyphae were present. Fungi were identified morphologically as species in the Zygomycetes class; in one case a Mucor sp. was cultured. Zygomycetes appear to be potentially serious opportunistic pathogens of ostrich chicks.
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PMID:Proventriculitis and ventriculitis associated with zygomycosis in ostrich chicks. 783 20

The adverse effects and treatment failures to some of the currently recommended drugs for giardia infection have given rise to the need for alternative antigiardial agents. In an open, randomized parallel group study, the safety and efficacy of albendazole was compared with that of metronidazole for the treatment of giardiasis in children. Sixty two children aged between 2-12 years were randomized to receive either albendazole suspension 400 mg daily for 5 days or metronidazole suspension 7.5 mg/kg thrice daily for 5 days. The mean days required for cure, as evident by absence of cysts and/or trophozoites in the stool specimen, was 3.7 + 1.4 and 4.5 + 1.1 days, respectively for children on albendazole and metronidazole therapy. Six children on metronidazole therapy developed anorexia 2 to 4 days after the treatment. Albendazole proved as effective as metronidazole in the treatment of giardia infection in children with the added advantage of absence of anorexia.
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PMID:A comparative clinical trial of albendazole versus metronidazole in giardiasis. 861 54


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