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Pathology
Giardia intestinalis (= lamblia/ duodenale).
Commonest intestinal protozoan parasite. Produces small bowel overgrowth, malabsorption predominates. Incubation: 3-21 days.
Aetiology
Worldwide distribution. Cysts can survive outside host for long periods in water facilitating spread, also exhibits person to person spread.
Signs
Low grade fever, dehydration.
Symptoms
Asymptomatic carriage.
Watery diarrhoea, steatorrhoea, abdominal discomfort, bloating, weight loss, fatigue, sulphurous belching, flatulence.
Investigations
Bloods: FBC, U&E
Microbiology: Stools for OCP (ova, cysts and parasites).
String test (swallow capsule containing end of string which
passes to duodenum. Giardia trophozoites cling onto string and
can be seen on microscopy when string is pulled out).
Treatment
Medical: Metronidazole 400mg TDS 5-10 days or Tinidazole as an alternative.
Prognosis
Generally good.
Severe malabsorption with growth retardation in children.
Key Facts
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Key References
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