MLS 306 – CLINICAL PARASITOLOGY (LECTURE)

FLAGELLATES - GIARDIA LAMBLIA

1st SEMESTER | S.Y. 2022-2023 TRANSCRIBED BY: CAILENE S. INFANTE
LECTURER: DOC KISHAN BHALANI
TOPIC OUTLINE
I. Flagellates
a. Giardia lamblia

FLAGELLATES

3 BASIC GROUPS OF FLAGELLATES

➔ Intestinal flagellates
➔ Tissue flagellates
➔ Blood flagellates

GENERAL BODY STRUCTURES OF FLAGELLATES

➔ Kinetosome
➔ Costa
➔ Cystotome
➔ Cytostome

GIARDIA LAMBLIA
Figure 2 giardia lamblia trophozoite
➔ Final Habitat:
➢ Duodenum of the small intestine
➔ Duodenal aspirate can be a laboratory sample
➔ Associated with:
➢ Malabsorption syndrome
➢ Steatorrhea
➔ It causes traveler's diarrhea and epidemic diarrhea

TROPHOZOITE
➔ Pear-shaped or teardrop shaped
➔ The only bilaterally symmetrical protozoan with
medial line called AXOSTYLE
➔ Referred to as:
➢ “Old Man’s Face / Old Man with Eyeglasses”
➢ Old man with whiskers
➢ Cartoon character Figure 3 Trophozoite in the Intestine
➢ Monkey’s face
➔ FALLING LEAF MOTILITY CYST
➔ With 2 anterior nuclei ➔ Footballshaped/ovoid
➢ four pairs of flagella ➔ With 2-4 nuclei
➔ With 2 sucking disks ➔ Cytoplasm often appears retracted
➔ The AXOSTYLE is made up of two axonemes, defined
as the interior portion of the flagella
➔ Two slightly curved rodlike structures, known as
Median Bodies, sit on the axonemes posterior to the
nuclei

Figure 4 Giardia lamblia cyst

Figure 1 Giardia lamblia trophozoite

Infante, Cailene S. [BS MLS 3F] 1

 DIAGNOSIS

➔ Demonstration of trophozoite and or cyst

➔ Duodeno-jejunal aspiration
➔ Biopsy
➔ Entero Test
➔ Antigen detection test
➢ Immunofluorescence
➢ immunochromatographic assays
➢ direct flourescent antibody
◼ gold standard
➢ PCR

EPIDEMIOLOGY

➔ The prevalence in the Philippines is less than 20%

and more common in children than in adults ( 6%)
➔ Homosexual
➔ Cysts have been found in dogs, cats, farm animals
and some wild animals
➔ Can be transmitted from fecally contaminated food
Figure 5 Giardia lamblia cyst ➔ Important risk factors include:
➢ Poor hygiene
➢ Poor sanitation
➢ Overcrowding
➢ Immunodeficiency
➢ Bacterial and fungal overgrowth in the small
intestine
➢ Homosexual practices.
➔ Related to “gay bowel syndrome”.

TREATMENT , PREVENTION AND CONTROL

➔ Proper water treatment

➢ chemical therapy and filtration
➔ Proper disposal of feces to prevent contamination of
water supply
➔ Prevent food from contamination due to the use of
human excreta as fertilizer for vegetables
➔ Prevent food from contamination from flies and
infected food handlers
➔ Avoidance of unprotected oral-anal sex

Figure 6 Giardia lamblia life cycle

PATHOLOGY

➔ It causes:
➢ traveller’s diarrhea
➢ epidemic diarrhea
➔ Associated with:
➢ Nausea
➢ anorexia
➢ crampy stomach
➔ The stool become light colored but not blood
streaked
➔ The diarrhea may become persistent, chronic and
associated with malabsorption so that the stool may
become steatorrheic
➔ Produce lectin
➔ Cause villous flattening and cyst hypertrophy.
➔ Typical incubation period is 10- 36 days
➔ Produce watery, foul-smelling diarrhea
➔ Self-limiting condition that typically is over in 10-14
days after onset

Infante, Cailene S. [BS MLS 3F] 2