Clinical Pathology: Microbiology

775) A 14-year-old boy presents to his pediatrician with a 1-week history of abdominal pain, diarrhea, and foul-smelling flatulence. Two weeks before presentation, he was camping with his scout troop and may have ingested water from a nearby stream. Direct examination of a fresh stool sample is shown in the figure. Which one of the following is the etiologic agent causing this patient’s illness?

Giardia intestinalis (also known as Giardia lamblia) is a protozoan parasite that can be present in diarrheal stool as either a trophozoite or a cyst.

• The G. intestinalis trophozoite is teardrop shaped and has four pairs of flagella, two nuclei, two linear axonemes, and two curved median bodies. The cyst form is oval and contains four nuclei, axenomes, and median bodies

• Giardia is transmitted by swallowing infectious cysts found in contaminated food or water. Water sources, such as ponds, lakes, and streams, harbor G. intestinalis cysts because of fecal contamination by animals and/or humans.

• Rapid immunochromatographic screening methods are more sensitive than routine ova and parasite examinations. Duodenal aspirates may also be examined for the presence of the parasite.

• Effective therapy for giardiasis includes metronidazole and nitazoxanide.

• Hallmark symptoms of giardiasis are explosive watery foul-smelling diarrhea and flatulence.



 
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