Inflammatory vs non-inflammatory Protozoal Diarrhea.pptx

Inflammatory vs non-inflammatory Protozoal Diarrhea- AMOEBIASIS, BALATANDIASIS, CRYPTOSPORIDIOSIS, GIARDIASIS

1. Inflammatory vs non-inflammatory Protozoal Diarrhea

2. Inflammatory Protozoal Diarrhea AMOEBIASIS BALATANDIASIS Entamoeba histolytica : Invasive, ulceration of the intestinal mucosa causing dysentery. Balantidium coli : Rare but invasive, causing mucosal destruction Asymptomatic  mild to severe dysentery  ulcerative colitis  Extraintestinal disease (liver abscess) Asymptomatic  persisting intermittent diarrhea  fulminant dysentery  ulcer  perforation (unlike amobiasis it doesn’t spread hematogenously ) Fecal -oral, waterborne, ingestion of cysts Fecal -oral, waterborne, ingestion of cysts, derived from porcine feces . Stool antigen tests, ELISA, PCR microscopic detection of the trophozoite stage in stool or sampled colonic tissue. Metronidazole or tinidazole initially + paromomycin, for cyst eradication Treatment. Tetracycline (500 mg q6h for 10 days) is effective against B. coli. Doxycycline, metronidazole, iodoquinol, and paromomycin are the alternatives.

3. non-inflammatory Protozoal Diarrhea CRYPTOSPORIDIOSIS GIARDIASIS Cryptosporidium spp. : Infects epithelial cells (especially in immunocompromised patients. Risk- children, traveller ). Giardia lamblia : Adheres to intestinal walls, causing malabsorption without invasion. profuse watery diarrhea , abdominal cramping, and, less commonly, nausea, anorexia, fever, and malaise. Asymptomatic  intermittent flatulence, mild and watery malodorous diarrhea  chronic malabsorption . Fecal -oral, waterborne, ingestion of cysts Fecal -oral, waterborne, ingestion of cysts Fecal antigen tests, ELISA, Microscopic examination of stool Fecal antigen tests, ELISA, Microscopic examination of stool Treatment- Nitazoxanide in patients without AIDS and with persistent infection, (ART) in patients with AIDS; nitazoxanide Treatment -Tinidazole, metronidazole, or nitazoxanide