BACKGROUND: Worldwide, Giardia lamblia is the most common protozoan isolated from the GI tract. Patients with symptoms caused by giardiasis typically present with diarrhea, the absence of which may result in a low clinical index of suspicion for the diagnosis. METHODS: A series of 6 patients with giardiasis presenting without diarrhea is reported. Five presented with atypical GI symptoms. In all 6 cases, diarrhea was absent. Upper GI pathology was suspected by the investigating clinician and EGD was therefore arranged. OBSERVATIONS: Five of the 6 patients improved with appropriate antibiotic treatment. CONCLUSION: This series of cases demonstrates the importance of considering G lamblia as a cause for GI symptoms even in the absence of diarrhea. Routine procurement of duodenal biopsy specimens is valuable for recognition of atypical presentations of patients with G lamblia and avoiding delays in diagnosis.
BACKGROUND: Worldwide, Giardia lamblia is the most common protozoan isolated from the GI tract. Patients with symptoms caused by giardiasis typically present with diarrhea, the absence of which may result in a low clinical index of suspicion for the diagnosis. METHODS: A series of 6 patients with giardiasis presenting without diarrhea is reported. Five presented with atypical GI symptoms. In all 6 cases, diarrhea was absent. Upper GI pathology was suspected by the investigating clinician and EGD was therefore arranged. OBSERVATIONS: Five of the 6 patients improved with appropriate antibiotic treatment. CONCLUSION: This series of cases demonstrates the importance of considering G lamblia as a cause for GI symptoms even in the absence of diarrhea. Routine procurement of duodenal biopsy specimens is valuable for recognition of atypical presentations of patients with G lamblia and avoiding delays in diagnosis.
Authors: Andrew D Hopper; Simon S Cross; David P Hurlstone; Mark E McAlindon; Alan J Lobo; Marios Hadjivassiliou; Marion E Sloan; Simon Dixon; David S Sanders Journal: BMJ Date: 2007-03-23