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Thursday, March 31, 2011

GIARDIASIS

Infection with the flagellate Gardia intestinalis known also as G.lamblia, is world-wide but commoner in the tropics.
 It particularly affects children in endemic areas, tourists, and patients in mental hospitals ans is the parasite most commonly imported in to Britain. The flagellates attach to the mucosa of the duodenum and jejunum and cause inflammation and partial villous atrophy.
Clinical features
Recurrent attacks of urgent diarrhoea with abdominal discomfort and explosive loose pale stools are characteristic. There may be severe malabsorption, lethargy, flatulence, abdominal distension, epigastric pain and nausea are common.
Diagnosis
Giardiasis is diagnosed by recognising the cysts in stools or the flagellate form in jejunal juice or mucus, which can be obtained via a biopsy capsule or a string test (Enterotest capsule). Repeated examination may be necessary.
Management
Treatment is with a single close of tinidazole 40 mg/kg in the range 0.5 g to 2g, repeated after 1 week. Metronidazole 200-400 mg t.i.d. for 14 days is less efficient.

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