Giardia Lamblia usually causes Giadiasis and learn with me on these summarized notes by R.Banda.ppt

What is giardiasis? Giardiasis is an intestinal infection caused by a microscopic parasite called Giardia. This parasite lives all over the world, especially in bodies of water. If you accidentally swallow it, it takes up residence in your small intestine and multiplies, feeding off the nutrients there.

1. GIADIASISGIADIASIS
Mr. R.BANDA
COG
Medical Parasitology

2. Anton Von Leeuwenhoek (1681) discovered
 
Giardia Lamblia 
originally
named
 
Cercomonas intestinalis, later also known as
 
Giardia intestinalis 
or 
Giardia
duodenale 
in his stools, making it one of the earliest known protozoan parasites.
Common Enteric infection caused by the protozoan G. Lamblia, usually attacks the
small intestines and slightly the upper ileum.
Systemic Classification:
Kingdom: Protista
Sub-kingdom: Protozoa
Phylum: Sarcomastigophora

4. MorphologyMorphology
Exists in
 Trophozoite (Vegetative form) and cystic form
Trophozoite
Pear shaped disk, broad rounded anterior end with a tapering posterior end.
It is bilaterally symmetrical with 2 median bodies, 2axonemes and 4 pairs of
flagella (lateral, ventral and caudal)
Cyst
Infective stage of the parasite
Oval/ Ellipsodial in shape measuring about 8-12 micrometer
Has a thick wall surrounding it and can be stained with Iodine to appear brown.

5. EpidemiologyEpidemiology
Reservoir Host: Man (Dogs and some other animals)
Source: Contaminated Water/ Food with Human Feces
Transmission: Feco-Oral Route, Rarely Sexual
Infective Dose: >10Cysts

6. LIFE CYCLE
Usually completed by one host.
Cysts are passed in stool from an
infected individual, when ingested, it
travels through the upper GI into the
stomach where Excystation occurs.
Each cyst gives rise to at least 2
trophozoites which travel to the
smaller intestines and begins
multiplication via binary fusion and
adhere to the enterocytes by the
ventral scuckers.
Those that reach the larger intestines
undergo Encystation and form
quadri-nucleated cysts and are
released in stool
Has an incubation period of about 1-
3weeks

7. Clinical Features
Damage to the intestinal walls pre-disposes one to having chronic diarrhoea
secondary to giardiasis and may lead to mal-absorptions of fat and
carbohydrates.
Acute Features
Watery Diarrhoea, Abdominal Cramps, Bloating, Flatulence
Chronic Features
Chronic Diarrhea with Mal-absorption of Fat, Vitamin A, Proteins and
Carbohydrates.
Weight loss, Malaise, Nausea and Anorexia

8. Complications
Growth Retardation
Weight Loss
Dehydration
Hypovolemic Shock
Delayed Milestones
Mal-nutrition

9. LAB Diagnosis
Trophozoite and cyst phases are found in stool specimen. The
stool normally is rough, heavy, yellow, oily, diarrheal, and
blood is not in the stool. Several specimens obtained at varying
periods ought to be studied as trophozoites and cysts are
irregularly excreted.
 The cyst of intestinal flagellates can easily be distinguished
from
 
G.lamblia 
because they are smaller and do not have the
same distinctive aspect as
 
G. Lamblia 
(do not have flagella
remains).

10. LAB Diagnosis
Primary Investigation
RDT
BS for MPs
Full Blood Count
Ultra Sound scan
Specific Investigations
Stool for MCS (Formed, Soft and Watery)
Duodenal Aspirates
Duodenal/ Jejuna Biopsy

11. Diagnosis
Stained Stool Smears
Trichrome/ Iron Haematoxylin stain can be used to demonstrate the
trophozoite
Stool Antigen Detection test like ELISA and Immunofluorescence can be used
in epidemics
ELISA is
 a laboratory technique that detects certain antibodies, antigens
and other substances in your blood, pee or other bodily fluid

12. TREATMENT
Primary Treat the clinical presentations:
If Dehydrated, Rehydrate the patient
If Hypoxic, Commence O2 at low flow and monitor pts. Saturations
If Electrolyte Imbalanced, Treat with at least Ringer Lactate to help in the balancing of
electrolytes as well as promoting rehydration
Metronidazole will help in the specific treatment and Prevents Complications