2. giardia
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2. giardia
- 2. Giardia Lamblia • The genus Giardia belongs to the class mastigophora (flagellates). • It is one of the most primitive eukaryotes. • G. lamblia (also called intestinalis or duodenalis) is the species infecting humans. • It occurs all over the world. • Habitat • Duodenum and upper part of jejunum
- 3. Morphology G. lamblia is found in following 2 stages: • Trophozoites • Cysts
- 4. Trophozoites &Cysts • Trophozoite: pear shaped, symmetric and 10-20m long by 6- 8m wide, 4 pairs of flagella with bilateral symmetry; 2 nuclei with central karyosomes and 2 axistyles. • Large concave sucking disk on anterior ventral surface. • Trophozoites found in upper 1/3rd of small intestine. • When swept into the colon they encyst. • Cysts: are 8-14m long, ellipsoid, contain 2-4 nuclei and have a thick (0.3 m) wall. • Ruminant flagellae and margins of sucking disc lie inside cytoplasm • They are passed in stools
- 6. Cysts are formed in bowel L I F E C Y C L E Cysts passed with stools Ingestion of edibles & water contaminated with cyst Acidic pH of stomach initiates excystation Which completed in duodenum thus release trophozoites Multiply by binary fission It can also localize in biliary tract
- 7. Life Cycle
- 8. Pathogenesis •The production of diarrhea, and occasionally malabsorption, is the result of a complex interaction of Giardia with the host, •Infection occurs after oral ingestion of as few as 10 to 25 cysts. •After excystation, trophozoites colonize and multiply in the upper small bowel •Adherence of G. lamblia in the human gut may be via the disk. •It may cause a disturbance of intestinal function, leading to malabsorption of fat.
- 9. Pathogenesis cotd…. •Disruption of the brush border •Mucosal invasion •Stimulation of an inflammatory infiltration leading to fluid and electrolyte secretion and occasionally to villous changes
- 10. Giardia Lamblia clinging to the wall of a duodenal villus.
- 11. •Acute onset of diarrhea •Abdominal cramps, bloating, and flatulence •Feelings of malaise, nausea, and anorexia •May complain of sulfuric belching •Vomiting, fever, and tenesmus occur less commonly. •Stools may be profuse and watery, but later they are commonly greasy, and foul-smelling and may float •Steatorrhea Clinical Features
- 12. Laboratory Diagnosis • Microscopic examination • Wet, saline mounts: falling leaf motion, fibrils present, and nucleic characteristics. • Biopsy tissue/duodenal aspirate stained by trichrome or Giemsa stain. • Enzyme immunoassay and fluorescent- anitbody monoclonal antigen detection systems •Treatment •Metronidazole •Quinacrine •Furazolidone •Tinidazole
- 13. PREVENTION The prevention of giardiasis requires proper handling and treatment of water Good personal hygiene on an individual basis Chlorination of water Bringing water to a boil is sufficient to kill all protozoal cysts; at high altitudes, boiling for longer periods may be necessary