Giardiasis and Giardia lamblia

Giardia lamblia is a gastrointestinal protozoa that results in a clinical picture ranging from asymptomatic colonization to acute or chronic diarrheal illness.

Clinical manifestations

· The majority of the infected individuals are asymptomatic.

· Symptoms develop 1-3 weeks after exposure to the parasites.

· The most common presentations are diarrhea, weight loss, crampy abdominal pain,  distension and failure to thrive.

· Malabsorption occurs in most of the patients.

Diagnosis

  · Stool analysis by several fecal sampling.

  · Endoscopy and taking duodenal aspirate and biopsy.

  · Antigen detection tests.

Treatment

- Asymptomatic excreters generally are not treated.

 Indication of therapy.

a- children with acute diarrhea.

b- children who manifest failure to thrive.

c- Children who manifest malabsorption or gasterointestinal tract symptoms such as chronic diarrhea.

One of the following drugs is used:

  · Albendazolel (400 mg PO once a day for 5 days among children 2-12 years of age).

  · Metronidazole 15mg/kg/ day divided into 3 doses for 5 days.

  · Furazolidone 6mg/kg in 4 divided doses for 10 days.

  · Tinidazole single oral dose of 50 mg/kg.