CASE REPORTS

Diagnosis of a case of Giardia lamblia infection

  • MIN Xiangyang ,
  • FENG Meng ,
  • ZHAO Xuhong ,
  • WENG Wenhao ,
  • LI Hanhua
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  • 1 Department of Clinical Laboratory, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
    2 School of Basic Medical Science, Fudan University, Shanghai 200032, China
    3 Department of Clinical Laboratory, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200062, China

Received date: 2023-12-09

  Revised date: 2024-02-22

  Online published: 2024-04-02

Supported by

Project of Science and Technology Department of Shanghai(20204Y0134)

Abstract

A 40-year-old male, who is a Shanghai resident, presented to the emergency department of Yangpu Hospital, School of Medicine, Tongji University in July 2018. The patient complained of watery diarrhea for 1 day. The patient had a travel history to Panama one month before the onset of the disease and had no history of drinking unboiled water or consuming uncooked meat. The routine blood cell count results were normal except for an increase in C-reactive protein of 16.17 mg/L (normal value 0-10 mg/L), which indicated an infection. Giardia trophozoites and cysts were found in stool specimens by microscopic examination. The IFA test results showed that G. lamblia trophozoites was recognized by the patient’s serum (1 ∶ 50), and there was strong fluorescence staining on the surface of G. lamblia. A 147 bp fragment of Giardia-specific 18S ribosomal RNA was amplified by PCR. The sequence of this fragment was 100% consistent with the sequence of G. lamblia assemblage A (GenBank login number: KY706490), and it was clustered on the same branch with G. lamblia assembly A in the phylogenetic tree constructed by the neighbour-joining method. Based on the patient’s clinical manifestations and relevant examination results, a G. lamblia infection diagnosis was made. The patient was treated with oral metronidazole at 20 mg/kg daily, divided into 3 doses and take for 7 days. Blood and fecal routine tests were re-examined two weeks later, and both results returned to normal. The patient’s condition was improved without recurrence of symptoms.

Cite this article

MIN Xiangyang , FENG Meng , ZHAO Xuhong , WENG Wenhao , LI Hanhua . Diagnosis of a case of Giardia lamblia infection[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2024 , 42(2) : 272 -274 . DOI: 10.12140/j.issn.1000-7423.2024.02.020

References

[1] Read C, Walters J, Robertson ID, et al. Correlation between genotype of Giardia duodenalis and diarrhoea[J]. Int J Parasitol, 2002, 32(2): 229-231.
[2] Cotton JA, Amat CB, Buret AG. Disruptions of host immunity and inflammation by Giardia duodenalis: potential consequences for co-infections in the gastro-intestinal tract[J]. Pathogens, 2015, 4(4): 764-792.
[3] Connor BA. Sequelae of traveler’s diarrhea: focus on postinfectious irritable bowel syndrome[J]. Clin Infect Dis, 2005, 41(Suppl 8): S577-S586.
[4] Halliez MCM, Buret AG. Extra-intestinal and long term consequences of Giardia duodenalis infections[J]. World J Gastroenterol, 2013, 19(47): 8974-8985.
[5] Liu H, Xu N, Shen YJ, et al. Infection and genotype of Giardia lamblia among HIV/AIDS patients in Guangxi[J]. Chin J Parasitol Parasit Dis, 2019, 37(3): 321-325. (in Chinese)
  (刘华, 徐宁, 沈玉娟, 等. 广西地区艾滋病病毒感染/艾滋病患者蓝氏贾第鞭毛虫感染情况及基因型分析[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(3): 321-325.)
[6] Koru O, Araz E, Inci A, et al. Co-infection of Giardia intestinalis and Cyclospora cayetanensis in an immunocompetent patient with prolonged diarrhea: case report[J]. J Microbiol, 2006, 44(3): 360-362.
[7] Doglioni C, De Boni M, Cielo R, et al. Gastric giardiasis[J]. J Clin Pathol, 1992, 45(11): 964-967.
[8] Tilahun M, Gedefie A, Belayhun C, et al. Helicobacter pylori pathogenicity islands and Giardia lamblia cysteine proteases in role of coinfection and pathogenesis[J]. Infect Drug Resist, 2022, 15: 21-34.
[9] Iwashita H, Sugamoto T, Takemura T, et al. Molecular epidemiology of Giardia spp. in northern Vietnam: potential transmission between animals and humans[J]. Parasite Epidemiol Control, 2021, 12: e00193.
[10] Liu Q, Zou Y, Yang WB, et al. Advances in the study of the epidemiology and genotypes of Giardia lambliain China[J]. J Pathog Biol, 2018, 13(1): 106-109. (in Chinese)
  (刘晴, 邹扬, 杨文彬, 等. 我国人体贾第虫病流行病学及基因分型的研究进展[J]. 中国病原生物学杂志, 2018, 13(1): 106-109.)
[11] Feng YY, Xiao LH. Zoonotic potential and molecular epidemiology of Giardia species and giardiasis[J]. Clin Microbiol Rev, 2011, 24(1): 110-140.
[12] Fink MY, Singer SM. The intersection of immune responses, microbiota, and pathogenesis in giardiasis[J]. Trends Parasitol, 2017, 33(11): 901-913.
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