Giardiasis, also called Giardia enteritis and lambliasis, is a protozoal infection of the small bowel.
Giardiasis occurs worldwide but is most common in developing countries and other areas where sanitation and hygiene are poor.
In the United States, giardiasis most frequently occurs in travelers who have recently returned from endemic areas, campers who drink nonpurified water from contaminated streams, male homosexuals, patients with congenital lgA deficiency, and children in day-care centers. Children in general are more likely to develop giardiasis than adults, probably because of frequent hand-to-mouth activity. Over the past 10 years, the parasite responsible for the disease has been found in municipal water sources, nursing homes, and day-care centers.
The prognosis is good; with treatment, the patient recovers completely. Without treatment, symptoms continue to wax and wane. Also, giardiasis doesn't confer immunity, so reinfections can occur.
The parasites live and reproduce in human or animal intestines. Once in the intestines, they attach to the inside of the intestinal wall, where they can disrupt the normal function of the intestines and compete for important nutrients. This leads to the symptoms of giardiasis.
Symptoms and Signs
The most common symptoms include:
An accurate diagnosis depends on examination of a fresh stool specimen for cysts or examination of duodenal aspirate or biopsy for trophozoites.
Giardiasis responds readily to metronidazole. Some patients (such as children) may instead be given furazolidone, but it isn't as effective. If the patient has severe diarrhea and oral fluid intake is inadequate, he may need parenteral fluid replacement to prevent dehydration.
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