Giardiasis Clinical manifestations

· Infection occurs through ingestion of the cysts. When the cysts reach the upper small intestine, each cyst liberates four trophozoites. The trophozoites colonize the lumen of the duodenum and proximal jeujenum where they attach to the brush border of the intestinal epithelial cells.

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, cramp abdominal pain, distension and failure to thrive.

· Malabsorption occurs in most of the patients
.Diagnosis

Treatment

One of the following drugs is used:

· Tinidazole: single oral dose of 50 mg/kg in children >3yr.

Nitazoxanide    

                    1-3 yr :100mg (5ml)bid for 3 days

                   4-11 yr :200mg (10ml)bid for 3 days

                    >12 yr :500mg bid for 3 days

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

 · Albendazole: 400 mg PO once a day for 5 days among children >6 years of age .

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