Orth T, Protzer U, Mayet W J, Meyer zum Büschenfelde K H
I. Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universität Mainz.
Z Gastroenterol. 1995 Mar;33(3):166-9.
A 35-year-old German woman presented after a three month journey to Sudan with intermittent, persistent watery diarrhea. Stool examination identified Giardia lamblia. The patient was unsuccessfully orally treated with metronidazol 250 mg three times a day for seven days and tinidazol 2 g as single dose. During a two week hospitalization we observed a total villous atrophy in a duodenal biopsy specimen in absence of celiac sprue or a immunodeficiency syndrome. We treated with metronidazol 500 mg three times a day intravenously and discharged the patient in good condition. This case report shows the variability of clinical presentation of infection with Giardia lamblia. Moreover, we demonstrate rarely found histological changes as reason for clinical presentation, unsuccessful oral treatment and malabsorption. The intravenous therapy lead to a permanent eradication of Giardia lamblia.
一名35岁的德国女性在前往苏丹旅行三个月后出现间歇性、持续性水样腹泻。粪便检查发现蓝氏贾第鞭毛虫。患者口服甲硝唑250毫克，每日三次，共七天，以及单剂量替硝唑2克治疗均未成功。在为期两周的住院期间，我们在十二指肠活检标本中观察到完全性绒毛萎缩，排除了乳糜泻或免疫缺陷综合征。我们给予患者静脉注射甲硝唑500毫克，每日三次，患者出院时情况良好。本病例报告显示了蓝氏贾第鞭毛虫感染临床表现的变异性。此外，我们证明了罕见的组织学变化是临床表现、口服治疗失败和吸收不良的原因。静脉治疗导致蓝氏贾第鞭毛虫被永久根除。
