parasitic disease: Giardiasis
Hi steemians going back to medical issues I would like to talk about Giardiasis an intestinal parasite which is important because it is a disease that mainly affects children, this type of parasitic disease is worldwide (cosmopolitan) , and equally affects developed and developing countries, contrary to what is popular knowledge that these parasitic diseases affect mainly developing countries.
The causal agent of the Giardiasis is the Giardia lamblia is a parasite of the order Diplomonadida also known as Giardia intestinalis or Giardia duodenalis is a unicellular parasite , that is to say a protozoan, has two forms: the trophozoite which is the cause of the disease, is the active form, these parasites is one of the largest that affects the human, measuring about 20 microns , it has 8 flagella that it uses to move, in the center it has a structure that serves to adhere to the intestinal wall.
Image extracted from: source edited by me
The other form of the parasite is the cyst which is the infecting form, which is in the environment and resistant to it, it does not have flagella so it has no movement and its metabolic activities are diminished so that it does not feeds.
The transmission cycle
To understand how the disease is acquired it is necessary to know the parasite's biological cycle , and this begins with the ingestion of the cysts which can infect from the moment they are excreted, it must be taken into account that only 10 cysts are enough to cause the disease, these cysts are resistant to both the environment and gastric acid but the latter stimulates the trophozoites to open and exit and this happens in the first part of the small intestine (duodenum) which begins to divide and some can adhere to the intestinal wall , causing the disease. When these trophozoites advance in the gastrointestinal tract they feel in conditions not suitable for their survival, they encyst and excrete, thus the cycle begins again.
In short, the transmission is fecal-oral, this is due to poor hygiene, it is also common in day care centers or geriatric, in food contaminated with cysts after cooking or in foods that are consumed raw but poorly washed and finally sexual contact oral-anal.
Clinics manifestations
The clinical forms vary from asymptomatic (more frequent in children) or symptomatic (always in adult) being the main symptom from diarrhea with malabsorption to fulminating diarrhea.
When the symptoms appear they appear after an incubation period of 5-7 days, the clinic is varied presenting: diarrhea with fat (steatorrhea), nausea, vomiting, flatulence, belching.
There is also the chronic form that symptoms appear slowly and these patients often do not remember history, diarrhea is not so abundant, what predominates or motivates the patient to go to the office are soft stools, flatulence and belching with foul odor and in more severe cases weight loss is observed. It is not known how, but non-intestinal symptoms sometimes appear, such as pruritus or ocular alterations.
The malabsorption can be noticed when observing:
- Weightloss
- Anemia
- Nutritional deficit
- Hypocalcemia (decrease in calcium)
- Hypoalbuminemia (decrease in proteins)
Although the parasite adheres to the intestine, it does not penetrate it, but it also injures it causing programmed death of the cells of the small intestine, barrier dysfunction causing malabsorption and lactose intolerance that are the most characteristic symptoms.
How to perform the diagnosis?
Well, like any syndrome or disease you have to have suspicion, then look for the identification of the parasite in the feces, you can do direct examination and preferably with stool samples because often the cysts are removed irregularly.
Preventive and control measures
PS: since you use images of the somewhat cartoonish trophozoite here I enclose another image.
Source: Trofozoite and cyst of Giardia lamblia
References:
-Fauci AS, et al. Harrison’s principles of internal medicine. Vol 2. 19th ed. New York: McGraw Hill; 2015
-Pabón J. et al. Consulta practica parasitologia clinica. 1er ed. Valencia: Medbook;2014.
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Love the medical issues, thank you for sharing this valuable information 😘
Love the medical issues, thank you for sharing this valuable information 😘
Thanks for reading, I love the medical problems too. <3