Giardia

Dr. Mejbah Uddin

Ahmed
Flagellates
 Flagellates are equipped with flagella.
 These are known to inhabit:
reproductive tract,
alimentary canal,
tissues
blood stream,
lymph vessels and
cerebrospinal fluid.
Classification of flaellates:
Flagellates inhabit the intestinal tract:
Giardia lamblia- Pathogenic
Dentamoeba fragilis- Nonpathogenic
Chilomastix mesnili – Nonpathogenic
T. hominis – Nonpathogenic
T. tinax – Nonpathogenic
Flagellates inhabit the urogenital tract:
Trichomonas vaginalis.
Blood and tissue flagellates:
Trypanosoma cruzi
Trypanosoma brucei
Leishmaina donovani
L. brasiliense
L. tropica
Giardia
 The parasite Giardia duodenalis also
known as G. lamblia or G. intestinalis was
the first parasitic protozoan of humans
seen by Antonie van Leeuwenhoek in
1681.
Risk factors:
 Children attend day care centers.
 Child care workers, parents of infected
children
 Who drink unfiltered, untreated water
 Swimmers while swimming in lakes, rivers,
ponds, and streams.
 Taxonomy:

Phylum- Metamonida,
Class- Trepomonida,
Order- Giardia,
Genus- Giardia,
Species- Giardia intestinalis.
 Morphology: Trophozoite & Cyst
 Trophozoite:

 is the active, motile feeding stage

 causes pathology in small intestine.
 approximately 12 - 15 um long and 5 - 9 um
wide.
 pear-shaped with a cytoskeleton, two nuclei
and four pairs of flagella.
 Cyst:

 are hardy and can survive several months in

cold water and resistant to chlorine.
 are oval size 5 - 10 um in diameter.
 contains four nuclei.
 are non motile and no longer adheres to the
mucosal surface.
 Life cycle at a glance:
 Stages: Cyst & Trophozoite
 Infective form: Cyst
 Pathogenic form: Trophozoite
 Route of infection: Fecal oral route
 Diagnostic form: Cyst & Trophozoite
Steps of life cycle:

Ingestion of cysts with contaminated water & food

↓
In the small intestine, trophozoites releases
↓
Multiply by longitudinal binary fission
↓
Encystation occurs as the parasites transit toward the
colon.
↓
Cyst & trophozoites passed in stool
 Pathogenesis: There are several theories that
include:
 Direct damage
 Apoptosis
 Disruption of tight junction
 Mechanical
 Direct damage: Trophozoite causes direct damage
to the intestinal brush border and mucosa.
 Apoptosis: In the small intestinal epithelial cells.
 Pathogenesis:
 Disruption of tight junction: This appears
to be that Trophozoites disrupt the tight
junctional zona-occludens and increases
permeability.
 Mechanical: Trophozoites interfere with the
fat absorption resulting in steatorrhea.
Clinical Features:
 Acute giardiasis: stetorrhea, abdominal
pain, bloating, nausea, and vomiting.
 Chronic giardiasis: recurrent malabsorption
may lead to malabsorption syndrome and
severe weight loss.
 Laboratory Diagnosis:
 Principle: Giardiasis can be diagnosed by
detection of cyst or trophozoite in feces,
duodenal fluid or duodenal biopsy.
 Alternate methods:
 Detection of parasites by immunofluorescence
 Antigen detection by: EIA, RIA.
 Direct fluorescent antibody (DFA) assay
 Detection of nucleic acid by PCR
String test: The organism can be detected
from duodenal content by string test.

Gelatin Capsule in Stomach