title: [Diagnostic and therapeutic problems in Lamblia infections].
abstract: A 28-year-old woman complained of chronic diarrhoea of about one year's duration, made worse by taking food. As a lactose tolerance test showed evidence of severe intolerance she was given a lactose-free diet, but this brought no improvement. Duodenal biopsy showed villous atrophy, and in the duodenal juice there were numerous flagellated lamblia. After a single oral dose of 2 g tinidazole the diarrhoea stopped, the lamblia disappeared, and the lactose intolerance and villous atrophy cleared up. Lamblia were also detected in the duodenal juice of a 50-year-old woman, but her infection was much more difficult to treat. Tinidazole (single dose of 2 g), metronidazole (800 mg twice daily for 6 days), ornidazole orally 500 mg twice daily for 10 days and ornidazole intravenously 500 mg twice daily for four days all proved ineffective. However, after a 5-day course of epsilon-9-aminacridine (100 mg three times daily by mouth) the diarrhoea ceased and both vegetative forms and lamblia cysts disappeared. These cases emphasize that lambliasis should be considered as a possible cause of severe chronic diarrhoea even when there is no history of travel abroad and when the symptoms are atypical. Conventional chemotherapeutic agents may be ineffective.
authors.affiliation: Abteilung für Gastroenterologie und Endokrinologie, Universität Göttingen.
authors.forename: U
authors.initials: U
authors.lastname: Leonhardt
authors.forename: R
authors.initials: R
authors.lastname: Ebert
authors.forename: W
authors.initials: W
authors.lastname: Bommer
authors.forename: A
authors.initials: A
authors.lastname: Schauer
mesh_terms: D000328:Adult; D000818:Animals; D001706:Biopsy; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000175:diagnosis / Q000628:therapy; D004359:Drug Therapy, Combination; D004386:Duodenum / Q000473:pathology; D005260:Female; D005872:Giardia / Q000302:isolation & purification; D005873:Giardiasis / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007419:Intestinal Secretions / Q000382:microbiology; D007787:Lactose Intolerance / Q000175:diagnosis / Q000628:therapy; D008875:Middle Aged
vernacular_title: Diagnostische und therapeutische Probleme bei Infektionen mit Lamblien.