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Clinical Features:
The spectrum varies from asymptomatic carriage to severe diarrhea and malabsorption.
Acute giardiasis develops after an incubation period of 1 to 14 days
(average of 7 days) and usually lasts 1 to 3 weeks.
Symptoms include diarrhea, abdominal pain, bloating, nausea, and vomiting.
In chronic giardiasis the symptoms are recurrent and malabsorption and debilitation may occur.
Laboratory Diagnosis:
Giardiasis is
diagnosed by the identification of cysts or trophozoites in the feces, using direct mounts
as well as concentration procedures. Repeated samplings may be necessary. In
addition, samples of duodenal fluid (e.g., Enterotest) or duodenal biopsy may demonstrate
trophozoites. Alternate methods for detection include antigen detection tests by
enzyme immunoassays, and detection of parasites by immunofluorescence. Both methods
are available in commercial kits.
Diagnostic findings
Treatment:
Several prescription
drugs are available to treat giardiasis including metronidazole and tinidazole. Nitazoxanide has provided some encouraging results in the management of giardiasis
in children. For additional information, see the recommendations in
The Medical Letter
(Drugs for Parasitic Infections).
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