Materiały źródłowe

• #1 Giardia infection (giardiasis) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/giardia-infection/symptoms-causes/syc-20372786

  Giardia infection (giardiasis) is one of the most common causes of waterborne disease in the United States. […] Call your doctor if you have loose stools, stomach cramping and bloating, and nausea lasting more than a week, or if you become dehydrated. […] Giardia parasites live in the intestines of people and animals. […] Infection occurs when you accidentally swallow the parasite cysts. […] The most common way to become infected with giardia is after swallowing unsafe (contaminated) water. […] Giardia infection is far more common in children than it is in adults. […] Giardia infection is rampant wherever sanitation is inadequate or water isn’t safe to drink. […] People who have anal sex or oral-anal sex without using a condom or other protection are at increased risk of giardia infection. […] Giardia infection is almost never fatal in industrialized countries. […] No drug or vaccine can prevent giardia infection.

• #2 Giardia infection (giardiasis) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/giardia-infection-giardiasis?content_id=CON-20372769

  Giardia infection (giardiasis) is an intestinal infection marked by stomach cramps, bloating, nausea and bouts of watery diarrhea. […] Giardia infection (giardiasis) is one of the most common causes of waterborne disease in the United States. […] To help diagnose giardia infection (giardiasis), your doctor is likely to test a sample of your stool. […] For accuracy, you may be asked to submit several stool samples collected over a period of days. […] The samples are then examined in a lab for the presence of parasites. […] Stool tests may also be used to monitor the effectiveness of any treatment you receive.

• #3 Giardiasis Workup: Approach Considerations, Stool Examination, Stool Antigen Detection

  https://emedicine.medscape.com/article/176718-workup

  The traditional basis of diagnosis is identifying Giardia intestinalis trophozoites or cysts in the stool of infected patients via a stool ova and parasite (OP) examination. However, in relatively more recent years, the advent of more objective techniques (eg, immunoassays, nucleic acid amplification techniques [NAATs]) has led to an increase in their use, rather than those that rely on subjective microscopic examination of fecal specimens for Giardia cysts. […] Stool examination may be performed on fresh specimens or after preservation with polyvinyl alcohol or 10% formalin (with appropriate staining). Ideally, three specimens from different days should be examined because of potential variations in fecal excretion of cysts. G intestinalis is identified in 50-70% of patients after a single stool examination and in more than 90% after three stool examinations.

• #4 Giardiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513239/

  Traditional giardiasis diagnosis involved identifying Giardia trophozoites or cysts through stool studies. However, more objective techniques, such as nucleic acid amplification techniques (NAATs), are now widely used. […] Stool antigen enzyme-linked immunosorbent assays are also available. […] These tests benefit screening in high-incidence situations, such as during an epidemic or in daycare centers. […] However, they should not replace stool microscopy. […] Detecting Giardia through microscopy can be challenging as the protozoa only intermittently shed. […] The sensitivity of microscopy can be increased by collecting 3 stool samples on different days. […] Polymerase chain reaction (PCR) techniques can identify Giardia in stool samples, even at low concentrations such as 10 parasites/100 microliter.

• #5 Giardiasis Workup: Approach Considerations, Stool Examination, Stool Antigen Detection

  https://emedicine.medscape.com/article/176718-workup

  The traditional basis of diagnosis is identifying Giardia intestinalis trophozoites or cysts in the stool of infected patients via a stool ova and parasite (OP) examination. However, in relatively more recent years, the advent of more objective techniques (eg, immunoassays, nucleic acid amplification techniques [NAATs]) has led to an increase in their use, rather than those that rely on subjective microscopic examination of fecal specimens for Giardia cysts. […] Stool examination may be performed on fresh specimens or after preservation with polyvinyl alcohol or 10% formalin (with appropriate staining). Ideally, three specimens from different days should be examined because of potential variations in fecal excretion of cysts. G intestinalis is identified in 50-70% of patients after a single stool examination and in more than 90% after three stool examinations.

• #6 Giardiasis – Wikipedia

  https://en.wikipedia.org/wiki/Giardiasis

  Giardiasis is diagnosed via stool tests. […] According to the CDC, the detection of antigens on the surface of organisms in stool specimens is the current test of choice for diagnosis of giardiasis and provides increased sensitivity over more common microscopy techniques. […] A trichrome stain of preserved stool is another method used to detect Giardia. […] Microscopic examination of the stool can be performed for diagnosis. This method is not preferred, however, due to inconsistent shedding of trophozoites and cysts in infected hosts. […] Immunologic enzyme-linked immunosorbent assay (ELISA) testing may be used for diagnosis. These tests are capable of a 90% detection rate or more. […] Serological tests are not helpful in diagnosis.

• #7 Giardia lamblia infection: review of current diagnostic strategies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6441489/

  The microscopic identification of Giardia spp. in fecal samples is considered as the gold standard method for the diagnosis of giardiasis. […] The sensitivity of microscopy techniques depends on using direct or concentration methods, the number of examined fecal samples and employment of professionally trained persons. […] The diagnosis of giardiasis in most cases is mainly confirmed by stool examination. […] Fecal concentration is a recommended and routine procedure that allows the detection of a small number of Giardia cysts may be missed by using wet mounts direct smear. […] Comparison of wet mounts smear and formalin-ether concentration techniques in the diagnosis of intestinal parasite has showed that formalin-ether concentration technique detected 65.26% of positive specimens for one or more intestinal parasites while the direct wet mount smear was only 34.74% sensitivity.

• #8 Giardia lamblia infection: review of current diagnostic strategies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6441489/

  A significant number of the infected individual was missed by using wet mount smear method. […] Immunodiagnostic test for Giardia spp. diagnostic includes immunoassay techniques such as ELISA for antibody detection and methods dependent on detection of Giardia intestinalis antigens in human fecal specimens. […] The overall conclusion of them with some exceptions is that immunoassay is more sensitive than or as sensitive as, microscopy fecal examination. […] One of the best antigens that have ever been used is Giardia stool antigen with a relative molecular mass of 65 Kda (GSA65) which presenst in both trophozoites and cysts. […] The reported sensitivity of Elisa-GSA65 for a single specimen varies between 95 and 100% with 100% specificity. […] Molecular diagnosis of giardiasis is not used in routine medical laboratories.

• #9 Giardiasis in Animals – Digestive System – Merck Veterinary Manual

  https://www.merckvetmanual.com/digestive-system/giardiasis-giardia/giardiasis-in-animals

  Giardiasis is an intestinal infection with the protozoan flagellate parasite Giardia spp. […] Diagnosis is usually by demonstration of cysts or antigens in fecal samples. […] The two main methods to diagnose Giardia infection are identification of Giardia cysts, and considerably less frequently, trophozoites in fecal samples and detection of Giardia antigen in fecal samples. […] Giardia cysts are oval (915 710 mcm) and can be detected in feces concentrated by the centrifugation-flotation technique using zinc sulfate (specific gravity 1.18). […] Because Giardia cysts are excreted intermittently, infections may be missed; therefore, several fecal examinations should be performed if giardiasis is suspected (eg, three samples collected over 35 consecutive days). […] Giardia antigen that occurs in feces can be a useful method to diagnose Giardia infection, should infection be suspected but no cysts observed on microscopic examination. […] Different tests vary in their sensitivity and specificity; information about these differences is proprietary.

• #10 Giardia lamblia infection: review of current diagnostic strategies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6441489/

  A significant number of the infected individual was missed by using wet mount smear method. […] Immunodiagnostic test for Giardia spp. diagnostic includes immunoassay techniques such as ELISA for antibody detection and methods dependent on detection of Giardia intestinalis antigens in human fecal specimens. […] The overall conclusion of them with some exceptions is that immunoassay is more sensitive than or as sensitive as, microscopy fecal examination. […] One of the best antigens that have ever been used is Giardia stool antigen with a relative molecular mass of 65 Kda (GSA65) which presenst in both trophozoites and cysts. […] The reported sensitivity of Elisa-GSA65 for a single specimen varies between 95 and 100% with 100% specificity. […] Molecular diagnosis of giardiasis is not used in routine medical laboratories.

• #11 Giardia lamblia infection: review of current diagnostic strategies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6441489/

  A significant number of the infected individual was missed by using wet mount smear method. […] Immunodiagnostic test for Giardia spp. diagnostic includes immunoassay techniques such as ELISA for antibody detection and methods dependent on detection of Giardia intestinalis antigens in human fecal specimens. […] The overall conclusion of them with some exceptions is that immunoassay is more sensitive than or as sensitive as, microscopy fecal examination. […] One of the best antigens that have ever been used is Giardia stool antigen with a relative molecular mass of 65 Kda (GSA65) which presenst in both trophozoites and cysts. […] The reported sensitivity of Elisa-GSA65 for a single specimen varies between 95 and 100% with 100% specificity. […] Molecular diagnosis of giardiasis is not used in routine medical laboratories.

• #12 Giardiasis Workup: Approach Considerations, Stool Examination, Stool Antigen Detection

  https://emedicine.medscape.com/article/176718-workup

  Stool OP testing aids in the diagnosis of giardiasis in 80-85% of patients. It remains the diagnostic method with which other tests are compared. […] Stool antigen enzyme-linked immunosorbent assays also are available. These tests are similar to the stool OP test in terms of cost and have a sensitivity of 88-98% and a specificity of 87-100%. […] If the results from three OP tests are negative and giardiasis is still suspected, stool antigen enzyme-linked immunosorbent assay (ELISA) may be helpful. […] Stool culture is not routinely used because of the difficulty of reproducibly isolating Giardia from patient fecal samples. […] Routine laboratory tests (eg, complete blood cell count, electrolyte levels) are often unremarkable. […] Because immunoglobulin G (IgG) levels remain elevated for long periods, they are not beneficial in making the diagnosis of acute giardiasis. Serum anti-Giardia immunoglobulin M (IgM) can be beneficial in distinguishing between acute infections and past infections.

• #13 Giardia Lamblia (Giardiasis) Causes, Symptoms, Treatment

  https://www.medicinenet.com/giardia_lamblia/article.htm

  Giardiasis is a parasitic infection of the small intestine. […] Diagnosis of giardiasis. […] The best single test for diagnosing giardiasis is antigen testing of the stool. For antigen testing, a small sample of stool is tested for the presence of Giardial proteins. The antigen test will identify more than 90% of people infected with Giardia. […] Giardia also can be diagnosed by examination of stool under the microscope for cysts or trophozoites; however, it takes three samples of stool to diagnose 90% of cases. […] Other tests that can be used for diagnosing giardiasis are the collection and examination of fluid from the duodenum or biopsy of the small intestine, but these require tests that involve expense and discomfort. […] The string test is a more comfortable method for obtaining a sample of duodenal fluid. […] Although more comfortable than some of the other tests, it is not clear how sensitive the string test is in diagnosing giardiasis.

• #14 Giardia lamblia infection: review of current diagnostic strategies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6441489/

  Real-time PCR has been reported to be more sensitive and beneficial than Elisa and faecal microscopy for diagnosing G. intestinalis infection. […] Giardia spp. is one of the most common waterborne parasites that infected human. […] It is well known that no traditional or new methods can detect all cases of Giardia infection.

• #15 Giardia lamblia infection: review of current diagnostic strategies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6441489/

  Real-time PCR has been reported to be more sensitive and beneficial than Elisa and faecal microscopy for diagnosing G. intestinalis infection. […] Giardia spp. is one of the most common waterborne parasites that infected human. […] It is well known that no traditional or new methods can detect all cases of Giardia infection.

• #16 Giardiasis Workup: Approach Considerations, Stool Examination, Stool Antigen Detection

  https://emedicine.medscape.com/article/176718-workup

  No imaging studies are required in the workup of giardiasis. […] Stool examination for trophozoites or cysts is the traditional method for diagnosing giardiasis. […] Several tests to detect Giardia antigen in the stool are commercially available. These utilize either an immunofluorescent antibody (IFA) assay or a capture enzyme-linked immunosorbent assay (ELISA) against cyst or trophozoite antigens. […] Polymerase chain reaction (PCR) techniques may detect giardia in stool samples with parasites concentrations as low as 10 parasites/100 mcL. […] The string test (Entero-test) consists of a gelatin capsule containing a nylon string with a weight attached to it. […] Esophagogastroduodenoscopy (EGD) may be employed in patients in whom the diagnosis is suspected but unproven after stool microscopy and ELISA. […] Biopsy can also be used to visualize changes in histologic features. Intestinal biopsy shows flattened, mild lymphocytic infiltration and trophozoites on the surface. […] No classic universal histologic abnormalities result from infection with G intestinalis.

• #17 Systematic Review of Diagnostic Approaches for Human Giardiasis: Unveiling Optimal Strategies

  https://www.mdpi.com/2075-4418/14/4/364

  While ELISAs boast commendable attributes, encompassing expeditiousness and sensitivity, they are not without noteworthy drawbacks, notably high costs and the imperative acquisition of supplementary equipment such as an ELISA reader. The realm of emerging molecular techniques, pivoting around the amplification of parasite DNA, prominently features the PCR technique. Quantitative polymerase chain reaction (qPCR)-based assays unfurl a promising vista for diagnosing infections, showcasing commendable sensitivity and specificity that enables the direct detection of Giardia DNA from fecal samples. […] Reflecting on the data at hand, it becomes apparent that, concerning the diagnosis of giardiasis, the majority of published works gravitate towards microscopy, followed by PCR and subsequently ELISA. This hierarchy is intrinsically tied to the economic aspect; microscopic examination of stool samples stands out as the most cost-effective method, obviating the need for large-scale equipment such as an ELISA plate reader or a PCR thermal cycler.

• #18 Giardiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513239/

  Traditional giardiasis diagnosis involved identifying Giardia trophozoites or cysts through stool studies. However, more objective techniques, such as nucleic acid amplification techniques (NAATs), are now widely used. […] Stool antigen enzyme-linked immunosorbent assays are also available. […] These tests benefit screening in high-incidence situations, such as during an epidemic or in daycare centers. […] However, they should not replace stool microscopy. […] Detecting Giardia through microscopy can be challenging as the protozoa only intermittently shed. […] The sensitivity of microscopy can be increased by collecting 3 stool samples on different days. […] Polymerase chain reaction (PCR) techniques can identify Giardia in stool samples, even at low concentrations such as 10 parasites/100 microliter.

• #19 Giardiasis Workup: Approach Considerations, Stool Examination, Stool Antigen Detection

  https://emedicine.medscape.com/article/176718-workup

  No imaging studies are required in the workup of giardiasis. […] Stool examination for trophozoites or cysts is the traditional method for diagnosing giardiasis. […] Several tests to detect Giardia antigen in the stool are commercially available. These utilize either an immunofluorescent antibody (IFA) assay or a capture enzyme-linked immunosorbent assay (ELISA) against cyst or trophozoite antigens. […] Polymerase chain reaction (PCR) techniques may detect giardia in stool samples with parasites concentrations as low as 10 parasites/100 mcL. […] The string test (Entero-test) consists of a gelatin capsule containing a nylon string with a weight attached to it. […] Esophagogastroduodenoscopy (EGD) may be employed in patients in whom the diagnosis is suspected but unproven after stool microscopy and ELISA. […] Biopsy can also be used to visualize changes in histologic features. Intestinal biopsy shows flattened, mild lymphocytic infiltration and trophozoites on the surface. […] No classic universal histologic abnormalities result from infection with G intestinalis.

• #20 Giardiasis Symptoms, Treatment, Diagnosis & Cause

  https://www.emedicinehealth.com/giardiasis/article_em.htm

  Another method of diagnosis that is commonly used as a screening tool in outbreaks or in day care centers is antigen assay of stool. This method detects a certain protein found in the wall of Giardia lamblia. A stool sample is mixed with a solution that detects the cysts in the stool. […] The string test involves swallowing a fuzzy string enclosed in a gelatin capsule. The free end of the string is taped to the person’s cheek. Once swallowed, the string collects secretions and mucus from the small bowel. Four hours later the string is pulled back out and examined for organisms. […] This is the most invasive method of diagnosis. After the passage of a small tube (endoscope) through the person’s mouth and stomach into the small bowel, the doctor removes a small amount of tissue for examination. This method is reserved for difficult cases in which the cause of diarrhea cannot be determined using other methods. It allows for visualization of all abnormalities of the small intestine, which may cause diarrhea including giardiasis.

• #21 Giardiasis Workup: Approach Considerations, Stool Examination, Stool Antigen Detection

  https://emedicine.medscape.com/article/176718-workup

  No imaging studies are required in the workup of giardiasis. […] Stool examination for trophozoites or cysts is the traditional method for diagnosing giardiasis. […] Several tests to detect Giardia antigen in the stool are commercially available. These utilize either an immunofluorescent antibody (IFA) assay or a capture enzyme-linked immunosorbent assay (ELISA) against cyst or trophozoite antigens. […] Polymerase chain reaction (PCR) techniques may detect giardia in stool samples with parasites concentrations as low as 10 parasites/100 mcL. […] The string test (Entero-test) consists of a gelatin capsule containing a nylon string with a weight attached to it. […] Esophagogastroduodenoscopy (EGD) may be employed in patients in whom the diagnosis is suspected but unproven after stool microscopy and ELISA. […] Biopsy can also be used to visualize changes in histologic features. Intestinal biopsy shows flattened, mild lymphocytic infiltration and trophozoites on the surface. […] No classic universal histologic abnormalities result from infection with G intestinalis.

• #22 Giardiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513239/

  Standard ova and parasite laboratory testing might not routinely include Giardia testing. […] Therefore, the CDC advises healthcare providers to make specific requests for Giardia testing when submitting stool samples. […] Esophagogastroduodenoscopy (EGD) could be considered in cases where the diagnosis is suspected but not confirmed after stool microscopy and ELISA.

• #23 Giardia infection (giardiasis) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/giardia-infection/symptoms-causes/syc-20372786

  Giardia infection (giardiasis) is one of the most common causes of waterborne disease in the United States. […] Call your doctor if you have loose stools, stomach cramping and bloating, and nausea lasting more than a week, or if you become dehydrated. […] Giardia parasites live in the intestines of people and animals. […] Infection occurs when you accidentally swallow the parasite cysts. […] The most common way to become infected with giardia is after swallowing unsafe (contaminated) water. […] Giardia infection is far more common in children than it is in adults. […] Giardia infection is rampant wherever sanitation is inadequate or water isn’t safe to drink. […] People who have anal sex or oral-anal sex without using a condom or other protection are at increased risk of giardia infection. […] Giardia infection is almost never fatal in industrialized countries. […] No drug or vaccine can prevent giardia infection.

• #24 Giardiasis – NYC Health

  https://www.nyc.gov/site/doh/health/health-topics/giardiasis.page

  Giardiasis is an intestinal illness caused by a microscopic parasite called Giardia lamblia. […] Health care providers can detect the infection through stool tests. […] Medicines for treatment such as metronidazole, tinidazole or nitazoxanide can be prescribed by a health care provider. […] Food handlers, health care workers and children in day care must get approval from the Health Department before they can return to work or school. This involves follow-up stool testing.

• #25 Giardiasis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/353

  Giardiasis symptoms vary from asymptomatic passage of cysts to acute self-limiting diarrhea or chronic diarrhea. […] Diagnosis is by detection of cysts or trophozoites in a stool sample or by molecular-based detection of antigens or parasite-specific nucleic acids. […] Microscopy with direct fluorescent antibody testing is the gold standard for diagnosing giardiasis. […] Diagnostic tests include direct fluorescence antibody (DFA) test, enzyme-linked immunosorbent assay, nucleic acid amplification test, polymerase chain reaction of stool sample, stool microscopy, and CBC.

• #26 Giardiasis – Symptoms, Causes, Images, and Treatment Options

  https://www.epocrates.com/online/diseases/353/giardiasis

  Giardiasis symptoms vary from asymptomatic passage of cysts to acute self-limiting diarrhea or chronic diarrhea. It is associated with growth restriction in children. […] Diagnosis is by detection of cysts or trophozoites in a stool sample or by molecular-based detection of antigens or parasite-specific nucleic acids. […] Microscopy with direct fluorescent antibody testing is the gold standard for diagnosing giardiasis. […] Centers for Disease Control and Prevention. Giardia: clinical testing and diagnosis for Giardia infection. Feb 2024 [internet publication].[Full Text]

• #27 Clinical Testing and Diagnosis for Giardia Infection | Giardia | CDC

  https://www.cdc.gov/giardia/hcp/diagnosis-testing/index.html

  Healthcare providers can order laboratory tests to identify Giardia parasites in the stool of someone who is sick. […] Diagnostic laboratories can recommend one of several tests to confirm a giardiasis diagnosis. […] CDC recommends collecting three stool samples from patients over several days for accurate test results. […] Microscopy with direct fluorescent antibody testing (DFA) is the gold standard for diagnosing giardiasis. […] Finding Giardia in a patient’s stool confirms that they have a Giardia infection. […] Healthcare providers and laboratories should report laboratory-confirmed cases to their local or state health department.

• #28 Giardiasis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/353

  Giardiasis symptoms vary from asymptomatic passage of cysts to acute self-limiting diarrhoea or chronic diarrhoea. […] Diagnosis is by detection of cysts or trophozoites in a stool sample or by molecular-based detection of antigens or parasite-specific nucleic acids. […] Microscopy with direct fluorescent antibody testing is the gold standard for diagnosing giardiasis. […] Diagnostic investigations include direct fluorescence antibody (DFA) test, enzyme-linked immunosorbent assay, nucleic acid amplification test, polymerase chain reaction of stool sample, stool microscopy, and FBC.

• #29 Giardiasis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/intestinal-protozoa-and-microsporidia/giardiasis

  Giardiasis is infection with the flagellated protozoan Giardia duodenalis (G. lamblia, G. intestinalis). […] Diagnosis is by identifying the organism in fresh stool or duodenal contents, by assays for Giardia antigen, or molecular testing for parasite DNA in stool. […] Enzyme immunoassay for antigen or molecular test for parasite DNA in stool. […] Enzyme immunoassay to detect parasite antigen in stool is more sensitive than microscopic examination. […] Molecular tests for parasite DNA in stool are available. […] For symptomatic giardiasis, tinidazole, metronidazole, secnidazole, or nitazoxanide are used. […] Even after parasitologic cure, patients may experience lactose intolerance, irritable bowel syndrome, or fatigue that last for weeks to months. […] Guidelines for managing recurrent giardiasis infections and treatment failures are available (see CDC: Giardia: Diagnosis and Treatment Information for Medical Professionals).

• #30 Testing and Diagnosis for Giardia Infection | Giardia | CDC

  https://www.cdc.gov/giardia/testing/index.html

  Talk to a healthcare provider if you think you may be sick from Giardia. […] They may ask you for stool (poop) samples to check for Giardia. […] If you have Giardia in your poop, it means Giardia is likely making you sick. […] If you have diarrhea or other symptoms of a Giardia infection, talk to a healthcare provider about whether you should get tested. […] To see if Giardia is making you sick, a healthcare provider will ask you for one or more stool (poop) samples. […] They will send your samples to a laboratory to check if you have Giardia germs in your poop. […] If the laboratory finds Giardia in your poop, it means you have a Giardia infection. […] You may be asked to submit several stool samples collected over several days to see if you have a Giardia infection. […] The laboratory may need several samples because it can be difficult to detect Giardia in poop. […] Even if you have a Giardia infection, there may not be enough Giardia germs in every stool sample for the laboratory to find them. […] Additionally, people with Giardia infections do not pass Giardia germs every time they poop.

• #31 Giardiasis Workup: Approach Considerations, Stool Examination, Stool Antigen Detection

  https://emedicine.medscape.com/article/176718-workup

  Stool OP testing aids in the diagnosis of giardiasis in 80-85% of patients. It remains the diagnostic method with which other tests are compared. […] Stool antigen enzyme-linked immunosorbent assays also are available. These tests are similar to the stool OP test in terms of cost and have a sensitivity of 88-98% and a specificity of 87-100%. […] If the results from three OP tests are negative and giardiasis is still suspected, stool antigen enzyme-linked immunosorbent assay (ELISA) may be helpful. […] Stool culture is not routinely used because of the difficulty of reproducibly isolating Giardia from patient fecal samples. […] Routine laboratory tests (eg, complete blood cell count, electrolyte levels) are often unremarkable. […] Because immunoglobulin G (IgG) levels remain elevated for long periods, they are not beneficial in making the diagnosis of acute giardiasis. Serum anti-Giardia immunoglobulin M (IgM) can be beneficial in distinguishing between acute infections and past infections.

• #32 Giardia lamblia infection: review of current diagnostic strategies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6441489/

  The microscopic identification of Giardia spp. in fecal samples is considered as the gold standard method for the diagnosis of giardiasis. […] The sensitivity of microscopy techniques depends on using direct or concentration methods, the number of examined fecal samples and employment of professionally trained persons. […] The diagnosis of giardiasis in most cases is mainly confirmed by stool examination. […] Fecal concentration is a recommended and routine procedure that allows the detection of a small number of Giardia cysts may be missed by using wet mounts direct smear. […] Comparison of wet mounts smear and formalin-ether concentration techniques in the diagnosis of intestinal parasite has showed that formalin-ether concentration technique detected 65.26% of positive specimens for one or more intestinal parasites while the direct wet mount smear was only 34.74% sensitivity.

• #33 Giardiasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513239/

  Traditional giardiasis diagnosis involved identifying Giardia trophozoites or cysts through stool studies. However, more objective techniques, such as nucleic acid amplification techniques (NAATs), are now widely used. […] Stool antigen enzyme-linked immunosorbent assays are also available. […] These tests benefit screening in high-incidence situations, such as during an epidemic or in daycare centers. […] However, they should not replace stool microscopy. […] Detecting Giardia through microscopy can be challenging as the protozoa only intermittently shed. […] The sensitivity of microscopy can be increased by collecting 3 stool samples on different days. […] Polymerase chain reaction (PCR) techniques can identify Giardia in stool samples, even at low concentrations such as 10 parasites/100 microliter.

• #34 Systematic Review of Diagnostic Approaches for Human Giardiasis: Unveiling Optimal Strategies

  https://www.mdpi.com/2075-4418/14/4/364

  While ELISAs boast commendable attributes, encompassing expeditiousness and sensitivity, they are not without noteworthy drawbacks, notably high costs and the imperative acquisition of supplementary equipment such as an ELISA reader. The realm of emerging molecular techniques, pivoting around the amplification of parasite DNA, prominently features the PCR technique. Quantitative polymerase chain reaction (qPCR)-based assays unfurl a promising vista for diagnosing infections, showcasing commendable sensitivity and specificity that enables the direct detection of Giardia DNA from fecal samples. […] Reflecting on the data at hand, it becomes apparent that, concerning the diagnosis of giardiasis, the majority of published works gravitate towards microscopy, followed by PCR and subsequently ELISA. This hierarchy is intrinsically tied to the economic aspect; microscopic examination of stool samples stands out as the most cost-effective method, obviating the need for large-scale equipment such as an ELISA plate reader or a PCR thermal cycler.

• #35 Giardiasis in Cats | Today’s Veterinary Nurse

  https://todaysveterinarynurse.com/parasitology/giardiasis-in-cats/

  Giardiasis in cats is an infection caused by the single-celled protozoal parasites Giardia duodenalis (also known as G intestinalis and G lamblia) or G cati. […] Polymerase chain reaction (PCR) testing is available at commercial laboratories to identify the specific assemblage responsible for causing an infection. […] Presence of cysts or trophozoites indicates a definitive diagnosis of giardiasis, but their absence does not indicate a negative diagnosis. […] Enzyme-linked immunosorbent assays (ELISAs) are available for veterinary use. […] Sensitivity and specificity of the ELISA are similar to those of fecal flotation testing (85.3%), and when combined, the sensitivity increases to 97.8%. […] Additional testing done at diagnostic laboratories includes direct immunofluorescence assays (require fluorescent microscopy) and PCRs (can determine to which assemblage an infection belongs).

• #36 Giardia infection (giardiasis) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/giardia-infection/diagnosis-treatment/drc-20372790

  To help diagnose giardia infection (giardiasis), your doctor is likely to test a sample of your stool. For accuracy, you may be asked to submit several stool samples collected over a period of days. The samples are then examined in a lab for the presence of parasites. Stool tests may also be used to monitor the effectiveness of any treatment you receive. […] There are no consistently recommended medications for giardia infection in pregnancy because of the potential for harmful drug effects to the fetus. If your symptoms are mild, your doctor may recommend delaying treatment until after the first trimester or longer. If treatment is necessary, discuss the best available treatment option with your doctor.

• #37 Companion Animal Parasite Council | Giardia

  https://capcvet.org/guidelines/giardia/

• #38 Companion Animal Parasite Council | Giardia

  https://capcvet.org/guidelines/giardia/

• #39 Giardiasis: What It Is, Symptoms, Treatments & Medications

  https://my.clevelandclinic.org/health/diseases/15238-giardiasis

  Giardiasis is an intestinal infection caused by a microscopic parasite called Giardia. […] A healthcare provider can diagnose giardiasis by testing a sample of your poop for evidence of Giardia. […] Healthcare providers often prescribe medications to treat giardiasis based on your symptoms alone, without needing to diagnose it first. […] If you have symptoms, your healthcare provider can prescribe antiparasitic medications to make the infection go away faster. […] If you continue to have symptoms for longer than six weeks, visit your healthcare provider. […] It’s important to see a healthcare provider if you have symptoms lasting longer than six weeks.

• #40 Clinical Testing and Diagnosis for Giardia Infection | Giardia | CDC

  https://www.cdc.gov/giardia/hcp/diagnosis-testing/index.html

  Healthcare providers can order laboratory tests to identify Giardia parasites in the stool of someone who is sick. […] Diagnostic laboratories can recommend one of several tests to confirm a giardiasis diagnosis. […] CDC recommends collecting three stool samples from patients over several days for accurate test results. […] Microscopy with direct fluorescent antibody testing (DFA) is the gold standard for diagnosing giardiasis. […] Finding Giardia in a patient’s stool confirms that they have a Giardia infection. […] Healthcare providers and laboratories should report laboratory-confirmed cases to their local or state health department.

• #41 Giardiasis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/giardiasis/

  Diagnosis of giardiasis involves analyzing stool using direct fluorescent antibody testing and microscopic confirmation of cysts or trophozoites. […] Test all patients with prolonged diarrhea and recent exposure to routes of transmission. […] Direct fluorescent antibody testing (gold standard): microscopic detection of Giardia antigens in stool with immunofluorescence. […] Stool microscopy: microscopic confirmation of cysts or multinucleated trophozoites. […] PCR: typically tests for a range of GI infectious pathogens, including Giardia. […] Gastroduodenoscopy: confirms trophozoites in duodenal fluids; may be considered if stool diagnostics are negative. […] Giardiasis is a notifiable disease in the US.

• #42 Giardia infection (giardiasis) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/giardia-infection/diagnosis-treatment/drc-20372790

  To help diagnose giardia infection (giardiasis), your doctor is likely to test a sample of your stool. For accuracy, you may be asked to submit several stool samples collected over a period of days. The samples are then examined in a lab for the presence of parasites. Stool tests may also be used to monitor the effectiveness of any treatment you receive. […] There are no consistently recommended medications for giardia infection in pregnancy because of the potential for harmful drug effects to the fetus. If your symptoms are mild, your doctor may recommend delaying treatment until after the first trimester or longer. If treatment is necessary, discuss the best available treatment option with your doctor.

• #43 Giardia infection (giardiasis) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/giardia-infection/symptoms-causes/syc-20372786

  Giardia infection (giardiasis) is one of the most common causes of waterborne disease in the United States. […] Call your doctor if you have loose stools, stomach cramping and bloating, and nausea lasting more than a week, or if you become dehydrated. […] Giardia parasites live in the intestines of people and animals. […] Infection occurs when you accidentally swallow the parasite cysts. […] The most common way to become infected with giardia is after swallowing unsafe (contaminated) water. […] Giardia infection is far more common in children than it is in adults. […] Giardia infection is rampant wherever sanitation is inadequate or water isn’t safe to drink. […] People who have anal sex or oral-anal sex without using a condom or other protection are at increased risk of giardia infection. […] Giardia infection is almost never fatal in industrialized countries. […] No drug or vaccine can prevent giardia infection.

• #44 Giardiasis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/176718-overview

  The cyst form of the protozoan is smooth-walled and oval in shape, measuring 8-12 micrometers long by 7-10 micrometers wide. As the cyst matures, nuclear division occurs and readies the cyst to release two trophozoites upon excystation. Once the host is infected, trophozoites may appear in the duodenum within minutes. […] The average duration of symptoms in all ages ranges from 3 to 10 weeks. […] The asymptomatic carriage rate in children may be as high as 20% in southern regions and in children younger than 36 months who attend daycare centers. Asymptomatic carriage may persist for several months. Many children with giardiasis who are symptomatic have been shown to spread the disease within their homes, and they may contribute to high endemic rates in their communities. […] Patients and at-risk individuals should be instructed regarding appropriate hygiene methods and signs/symptoms of infection. Emphasis should be placed on measures such as careful hand washing after changing diapers.

• #45 Giardiasis – NYC Health

  https://www.nyc.gov/site/doh/health/health-topics/giardiasis.page

  Giardiasis is an intestinal illness caused by a microscopic parasite called Giardia lamblia. […] Health care providers can detect the infection through stool tests. […] Medicines for treatment such as metronidazole, tinidazole or nitazoxanide can be prescribed by a health care provider. […] Food handlers, health care workers and children in day care must get approval from the Health Department before they can return to work or school. This involves follow-up stool testing.

• #46 Giardiasis: a diagnosis that should be considered regardless of the setting | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/giardiasis-a-diagnosis-that-should-be-considered-regardless-of-the-setting/DAF07AA78BBF889F98747918F5E10C2F

  Although Giardia, the aetiological agent of giardiasis, is one of the most prevalent intestinal parasitic infections world-wide, for industrialised countries, it is mainly appreciated as an imported disease with the minimal local transmission. […] Its detection and diagnosis present a challenge to physicians who may not be familiar with this infection. […] A better understanding of the characteristics of populations importing infections alongside improved methods to reliably classify infections as imported or acquired locally will help to ensure early and accurate diagnosis. […] There are several factors hampering the rapid diagnosis of Giardia infection in industrialised countries. […] Giardiasis may, therefore, go undiagnosed or may be treated inappropriately by physicians who are unfamiliar with this disease.

• #47 Giardiasis: a diagnosis that should be considered regardless of the setting | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/giardiasis-a-diagnosis-that-should-be-considered-regardless-of-the-setting/DAF07AA78BBF889F98747918F5E10C2F

  These scattered reports underline the need to enhance efforts to provide education among general practitioners and pediatricians to be aware of Giardia as a cause of indigenous cases of diarrhoea and on how best to diagnose and effectively treat them. […] If Giardia is suspected, the right specimen and specific tests must be ordered and sent to a laboratory where adequate diagnostic tools and skills are available. […] For laboratory diagnosis, a morphological determination by microscopy is the most commonly used method, which is simple and fast. […] Unfortunately, it is less sensitive, requires multiple sample examinations and concentration procedures and needs to be performed by well-trained technicians. […] The discovery of Giardia as the cause of a large waterborne outbreak in Bergen, Norway was delayed due to no history of travel abroad among the many patients seeking medical care for diarrhoeal disease.

• #48 Giardiasis: a diagnosis that should be considered regardless of the setting | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/giardiasis-a-diagnosis-that-should-be-considered-regardless-of-the-setting/DAF07AA78BBF889F98747918F5E10C2F

  These scattered reports underline the need to enhance efforts to provide education among general practitioners and pediatricians to be aware of Giardia as a cause of indigenous cases of diarrhoea and on how best to diagnose and effectively treat them. […] If Giardia is suspected, the right specimen and specific tests must be ordered and sent to a laboratory where adequate diagnostic tools and skills are available. […] For laboratory diagnosis, a morphological determination by microscopy is the most commonly used method, which is simple and fast. […] Unfortunately, it is less sensitive, requires multiple sample examinations and concentration procedures and needs to be performed by well-trained technicians. […] The discovery of Giardia as the cause of a large waterborne outbreak in Bergen, Norway was delayed due to no history of travel abroad among the many patients seeking medical care for diarrhoeal disease.

• #49 Giardiasis: a diagnosis that should be considered regardless of the setting | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/giardiasis-a-diagnosis-that-should-be-considered-regardless-of-the-setting/DAF07AA78BBF889F98747918F5E10C2F

  These scattered reports underline the need to enhance efforts to provide education among general practitioners and pediatricians to be aware of Giardia as a cause of indigenous cases of diarrhoea and on how best to diagnose and effectively treat them. […] If Giardia is suspected, the right specimen and specific tests must be ordered and sent to a laboratory where adequate diagnostic tools and skills are available. […] For laboratory diagnosis, a morphological determination by microscopy is the most commonly used method, which is simple and fast. […] Unfortunately, it is less sensitive, requires multiple sample examinations and concentration procedures and needs to be performed by well-trained technicians. […] The discovery of Giardia as the cause of a large waterborne outbreak in Bergen, Norway was delayed due to no history of travel abroad among the many patients seeking medical care for diarrhoeal disease.

• #50 Giardiasis: a diagnosis that should be considered regardless of the setting | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/giardiasis-a-diagnosis-that-should-be-considered-regardless-of-the-setting/DAF07AA78BBF889F98747918F5E10C2F

  This infection may also be accompanied with or without malabsorption, abdominal cramps, nausea, vomiting, increased flatulence and weight loss. […] The changing perspectives of the incidence and prevalence of giardiasis in industrialised countries, where it is still relatively neglected and underappreciated by practicing clinicians and maybe by caregivers, need to be taken into account. […] Giardiasis may exceed the current prevalence estimates. […] Currie et al. study reminds us that there are multiple potential areas for improvement in laboratory testing algorithms and diagnostic awareness of giardiasis.

• #51 Giardiasis: a diagnosis that should be considered regardless of the setting | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/giardiasis-a-diagnosis-that-should-be-considered-regardless-of-the-setting/DAF07AA78BBF889F98747918F5E10C2F

  This infection may also be accompanied with or without malabsorption, abdominal cramps, nausea, vomiting, increased flatulence and weight loss. […] The changing perspectives of the incidence and prevalence of giardiasis in industrialised countries, where it is still relatively neglected and underappreciated by practicing clinicians and maybe by caregivers, need to be taken into account. […] Giardiasis may exceed the current prevalence estimates. […] Currie et al. study reminds us that there are multiple potential areas for improvement in laboratory testing algorithms and diagnostic awareness of giardiasis.

• #52 Systematic Review of Diagnostic Approaches for Human Giardiasis: Unveiling Optimal Strategies

  https://www.mdpi.com/2075-4418/14/4/364

  Hence, derived from the outcomes delineated in this study, the adoption of microscopic concentration methods is recommended as the primary modality within clinical settings, given its manifold advantages. In instances where a negative result persists amid indicative symptoms, the implementation of the ELISA method is warranted, given its heightened sensitivity. Notably, the utilization of PCR would be more judicious in characterizing resilient species and strains, albeit hindered by its elevated cost.

• #53 Systematic Review of Diagnostic Approaches for Human Giardiasis: Unveiling Optimal Strategies

  https://www.mdpi.com/2075-4418/14/4/364

  Hence, derived from the outcomes delineated in this study, the adoption of microscopic concentration methods is recommended as the primary modality within clinical settings, given its manifold advantages. In instances where a negative result persists amid indicative symptoms, the implementation of the ELISA method is warranted, given its heightened sensitivity. Notably, the utilization of PCR would be more judicious in characterizing resilient species and strains, albeit hindered by its elevated cost.

• #54 Systematic Review of Diagnostic Approaches for Human Giardiasis: Unveiling Optimal Strategies

  https://www.mdpi.com/2075-4418/14/4/364

  Systematic Review of Diagnostic Approaches for Human Giardiasis: Unveiling Optimal Strategies […] Giardiasis, caused by the protozoan Giardia intestinalis, affects around 400 million people worldwide, emphasizing the critical need for accurate diagnosis to enhance human health, especially in children. A variety of diagnostic tools, including microscopic, immunological, and molecular methods, are available for detecting G. intestinalis infection. This systematic review assesses the reliability and applicability of these diagnostic modalities. Microscopic techniques, particularly Ritchie’s method, emerge as the primary choice, followed by enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). In conclusion, our analysis supports microscopic methods as the gold standard for giardiasis diagnosis. However, in cases where symptoms persist despite a negative diagnosis, employing more sensitive diagnostic approaches is advisable.

• #55 Stool Analysis for Giardiasis

  https://www.myactivehealth.com/hwcontent/content/testdetail/hw186040.html

  A stool sample is collected and analyzed for the presence of the parasite G. lamblia or its cysts. […] A stool analysis is done if the medical history and symptoms show that you may have giardiasis. […] If a giardia infection is present, the parasite or its cysts can be seen when the stool is looked at under a microscope. […] If giardiasis is suspected, an antigen test may be done on the stool or a sample of the fluid from the small intestine (duodenal contents). […] For an accurate diagnosis, most doctors recommend analyzing at least 3 samples, collected on alternate days. […] If Giardia lamblia is found in the first test (positive result), no more tests are needed. […] If chronic giardiasis is suspected, 3 stool samples may be collected 4 to 7 days apart to maximize the chances of finding the parasite.

• #56 Stool Test: Giardia Antigen | Rady Children’s Hospital

  https://www.rchsd.org/health-article/stool-test-giardia-antigen/

  The Giardia antigen test is used to make a diagnosis of giardiasis, the digestive tract illness caused by Giardia lamblia. […] A doctor may order the test if your child has symptoms such as watery diarrhea, abdominal pain, large amounts of intestinal gas, appetite loss, and nausea or vomiting, especially if theres been an outbreak of giardiasis at your childs school or daycare center, your child recently drank untreated water, or if your family recently visited a developing country. […] The test also may be used to determine if treatment for giardiasis has been effective. […] The antigen test is more sensitive in detecting Giardia lamblia than the ova and parasite (OP) exam, but it cant identify any other organisms or conditions that cause gastrointestinal distress. […] After the sample arrives at the laboratory, a technician puts a stool sample in contact with a chemical that changes color in the presence of products of the Giardia lamblia parasite. […] Its important to remember that the Gardia antigen test detects the presence of only that specific parasite, so the doctor may order additional tests to reach a definitive diagnosis.

• #57 Your Ultimate Guide To Parasite Giardia And Treatments

  https://sydneygutclinic.com/your-guide-to-parasite-giardia-and-treatments/

  Giardiasis is an infection of the small intestine caused by the microscopic parasite giardia lamblia. The diagnosis of giardiasis typically involves laboratory tests to detect the presence of the giardia parasite in stool samples. […] A stool sample is collected and examined under a microscope to look for the presence of giardia cysts or trophozoites (two stages of the lifecycle of a parasite), after which antigen testing, enzyme immunoassays (EIA), or immunofluorescence assays can be used to examine specific giardia antigens in stool samples faster than traditional microscopy. […] In some cases, particularly when stool samples are repeatedly negative but medical suspicions are high, a healthcare provider may perform an upper endoscopy to obtain a sample directly from the first part of the small intestine for examination.

• #58 Your Ultimate Guide To Parasite Giardia And Treatments

  https://sydneygutclinic.com/your-guide-to-parasite-giardia-and-treatments/

  If you suspect you have giardiasis or are experiencing symptoms, it’s crucial to consult a healthcare professional. They can guide you through the appropriate diagnostic process and recommend treatment if necessary. Self-diagnosis and treatment are not recommended, as mismanagement of the infection can lead to complications or a persistent infection.

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