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Case Reports
. 2023 Apr 25;5(4):acmi000476.v3.
doi: 10.1099/acmi.0.000476.v3. eCollection 2023.

Refractory giardiasis in a child with steroid-resistant nephrotic syndrome

Jitu Mani Kalita  1 , Kirtika Sharma  1 , Naila Mohammad  1 , Vibhor Tak  1 , Aliza Mittal  2 , Vijaya Lakshmi Nag  1
Affiliations
Case Reports

Refractory giardiasis in a child with steroid-resistant nephrotic syndrome

Jitu Mani Kalita et al. Access Microbiol. .

Abstract

Giardiasis is an infection of the small intestine caused by the protozoan parasite Giardia intestinalis and one of the most common parasitic intestinal diseases in humans worldwide. It mainly manifests as a self-limited illness in the case of immunocompetent patients and usually does not require treatment. However, immunodeficiency is a risk factor for the onset of severe Giardia infection. In this report, a case of recurrent giardiasis refractory to nitroimidazole therapy is presented. A 7-year-old male patient with steroid-resistant nephrotic syndrome came to our hospital because of chronic diarrhoea. The patient was on long-term immunosuppressive therapy. Microscopic examination of stool showed a significant number of trophozoites and cysts of G. intestinalis. Treatment with metronidazole for longer duration than recommended has failed to clear the parasite in the present case.

Keywords: Giardia intestinalis; corticosteroid; nephrotic syndrome; nitroimidazole.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Cysts (black arrow) and trophozoites (blue arrow) of Giardia intestinalis in wet mount preparation: (a) saline and (b) iodine. Magnification, 400×.
Fig. 2.
Fig. 2.
Chromotrope staining showing cysts (a) and trophozoites (b) of Giardia intestinalis. Magnification,1000×.
See this image and copyright information in PMC

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