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

Giardiasis has been reported increasingly among visitors to the Soviet Union and is found at epidemic and endemic levels in the United States. The main source of infection is contaminated water. Children, homosexual males, and patients with gastrectomy, achlorhydria, hypogammaglobulinemia, secretory IgA deficiency, or alteration in immune status are particularly susceptible to severe, often chronic, infection. Symptomatic giardiasis can be acute, subacute, or chronic. Symptoms are explosive, watery, foul-smelling stools or semisolid stools with evidence of steatorrhea; flatulence; abdominal distention; and weight loss. Diagnosis usually can be established by examination of stool or duodenal fluid for cysts or trophozoites. Quinacrine hydrochloride is the drug preferred for treatment, but metronidazole and furazolidone are also useful.
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PMID:Giardiasis: a common cause of diarrheal disease. 49 84

A one-year retrospective laboratory survey in Colorado revealed that 691 (3%) of 22,743 stool examinations for ova and parasites were positive for Giardia lamblia, a higher percentage than that reported from surveys outside of Colorado. The majority of infected residents who were surveyed had experienced an episode of chronic watery diarrhea (median duration 3.8 weeks) with bloating, flatulence, and weight loss (averaging 5.1 kg), and had responded to a course of metronidazole or quinacrine. A statewide telephone survey of 256 cases and matched controls identified: 1) and increased incidence of giardiasis in persons between the ages of 16 and 45, p less than .001, with males and females equally affected; and 2) a higher proportion of cases than controls who visited Colorado mountains (69% vs. 47%), camped out overnight (38% vs. 18%), and drank untreated mountain water (50% vs. 17%), p less than .001. Also identified was a correlation between the seasonal distribution of cases and degree of fecal contamination of mountain streams. These results indicated that G. lamblia is endemic in Colorado and that drinking untreated mountain water is an important cause of endemic ifection.
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PMID:Giardiasis in Colorado: an epidemiologic study. 84 82

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

During the period from March through November 1989, 70 children who were attended at the Pediatric Department at Central Hospital in Valencia, were enrolled in the study, it was thought that Giardia lamblia infection might be present. Giardia L. were identified using two different diagnostic procedures: from stool samples and duodenal aspirates for cysts or trophozoites examination. These children were treated with Metronidazole three dosage of 15, 30 and 50 mg/kg per day for a ten day period. Our study showed predominant giardiasis in children with ages ranging from 2 to 6 years old (60%) with a relationship between female and male sex 1.05:1. In this series, 72.8% of patients presented normal nutrition, and 55.7% of them were from the suburban area. The most frequent symptoms were abdominal pain, diarrhea, vomiting, abdominal distention, constipation and flatulence. The infants prevalent symptom was diarrhea (83.3%) and the older children and school children prevalent symptom was abdominal pain with 78.5 and 100% respectively. In this study, stool examination was positive in 97.1% of the children and duodenal aspirate was positive in all 70 children (100%); the first procedure showed predominant Giardia cysts (88.2%) and the second one showed predominant trophozoites (47.1%). All 70 patients (100%) were cured with Metronidazole to different dosage. Side effects were seen with only the maxim dose, such as nausea 40%, headache 10% and appearance of yeast into 50% of duodenal aspirate.
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PMID:[Giardia lamblia: comparison of two diagnostic methods and evaluation of response to treatment with metronidazole]. 184 30

In a retrospective study performed on 125 patients with histologically diagnosed giardiasis, it is shown that this disease can lead to a variegated picture involving numerous gastroenterological symptoms. The main symptoms noted were epigastralgia (41%), diarrhoea (32%), nausea and vomiting (23%), and loss of weight (20%). The material for histological diagnosis was obtained in hospitals in 49% of the cases, in the doctor's office in 32%, and in two gastroenterological rehabilitation centres in 19%. The average duration of symptoms before establishment of the diagnosis was 2.01 years (range: 1 week to 30 years). In only 8% of the cases was the disease preceded by a visit to an endemic area. Treatment with nitroamidazole preparations completely relieved symptoms in 78% of the patients and remained unsuccessful in 4%; for the remaining 18% of the patients, no follow-up data were available. On the basis of these results, it is recommended that in patients with upper abdominal pain, diarrhoea, loss of weight, meteorism, flatulence, nausea and vomiting, the possibility of giardiasis should be considered, and that during endoscopy, two or three forceps biopsies should be obtained from macroscopically normally-appearing mucosa of the descending part of the duodenum to enable a histological search for Giardia lamblia.
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PMID:Giardiasis--a simple diagnosis that is often delayed. 195 49

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 high index of suspicion and careful application of diagnostic methods are essential for accurate diagnosis of parasitic bowel diseases. The varied clinical spectrum of giardiasis, amebiasis, and strongyloidiasis emphasizes the need to consider these pathogens when patients present with gastrointestinal complaints. Giardiasis should be suspected in patients, especially returned travelers, with unexplained increase in stool frequency, particularly with bloating, flatulence, or vague systemic symptoms. Amebiasis must be considered in the differential diagnosis of any patient who presents with persistent diarrhea or signs of inflammatory bowel disease. Unexplained diarrheal illnesses associated with upper abdominal symptoms and eosinophilia should raise suspicion of the presence of strongyloidiasis. These findings in a patient with a compromised immune system or in a candidate for immunosuppressive therapy should prompt a thorough investigation to rule out this parasite, since disseminated strongyloidiasis often is fatal.
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PMID:Parasitic bowel disease: three pathogens important in primary care. 628 Jan 60

Giardia lamblia is the number one intestinal parasite in the United States. Symptoms of giardiasis include upper abdominal pain and distress, flatulence, nervousness, and diarrhea. Multiple stool specimens examined for ova and parasites by nonexpert parasitologists will frequently not provide the diagnosis, and special studies must then be done. Antibiotics, antidiarrheals, certain enema preparations, and oily laxatives can cause a temporary disappearance of parasites from the stool. Treatment of choice is a five-day course of quinacrine hydrochloride. Recently, attention has been brought to the fact that oral sex may be responsible for transmission in a significant number of cases of giardiasis.
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PMID:Giardiasis: a common, sexually transmissible parasitic diarrhea with pitfalls in diagnosis. 686 95

Until the early 1940s, Giardia lamblia was considered by virtually all to be a simple intestinal commensal that benignly fed on small amounts of ingested food, never to cause symptoms or invade tissue. In the past 35 years this organism has established itself, through epidemics in which other pathogens were ruled out, as a fairly common cause of human enteropathology. The most common forms of symptomatic giardial illness present initially to primary care physicians and invariably are diagnosed as "gastroenteritis" with a symptom complex of abdominal upset, diarrhea, cramping, flatulence, and belching. Unlike most enteritides, giardiasis may become chronic and cause severe weight loss, malabsorption, or generalized discomfort. Also, unlike most, the organism is quite sensitive to antimicrobials and may be simply eradicated. Therefore, it is crucial that the index of suspicion for this illness be raised among family physicians, since it may be treated at the primary care level instead of remaining unsuspected until eventually being referred for a major gastrointestinal evaluation.
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PMID:Giardiasis: a common and underrecognized enteric pathogen. 745 86


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