Persisting symptoms and duodenal inflammation related to Giardia duodenalis infection
Persisting symptoms and duodenal inflammation related to Giardia duodenalis infection
复制标题
DOI：
10.1016/j.jinf.2007.09.004
复制
发表时间：
2007-12-01
影响因子：
28.2
通讯作者：
Langeland, Nina
中科院分区：
文献类型：
--
作者：
Hanevik, Kurt;Flausken, Trygve;Langeland, Nina
目的：卑尔根发生大规模水传播贾第鞭毛虫感染后，尽管接受了甲硝唑治疗，一些患者仍出现持续的腹部症状。本研究旨在调查其症状的可能原因。方法：在 15 个月的时间内，通过前瞻性队列分析对 124 名转诊患者进行了标准化调查评估，包括十二指肠活检和抽吸、血液检测以及粪便寄生虫和钙卫蛋白检测。招募康复的受试者进行症状分析。结果。 40 名患者（32.3%）发现十二指肠贾第鞭毛虫持续感染。 57 名患者 (47.1%) 的十二指肠活检显示有炎症迹象。 34 名（87.2%）贾第虫阳性患者和 23 名（28.0%）贾第虫阴性患者存在显微镜下十二指肠炎症。持续的贾第鞭毛虫阳性、显微镜下十二指肠炎症和钙卫蛋白测试阳性之间存在显着相关性。十二指肠抽吸和十二指肠活检在诊断持续性贾第鞭毛虫病中表现不佳。结论：在甲硝唑治疗贾第鞭毛虫感染后症状持续存在的患者中，我们通常发现慢性贾第鞭毛虫感染和显微镜下十二指肠。炎症，尤其是病程少于 7 个月的患者。随着时间的推移，这两项发现都消退了。越来越多的调查无法确定持续症状的明确原因。这里记录的贾第鞭毛虫病后长期腹泻、腹胀、恶心和腹痛需要进一步研究。 (c) 2007 年英国感染学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: After a large waterborne outbreak of Giardia infection in Bergen, some patients experienced persisting abdominal symptoms despite metronidazole treatment. This study aimed at investigating possible causes for their symptoms.Methods: Over a 15 months period, 124 referred patients were evaluated in a prospective cohort analysis with a standardised investigation including duodenal biopsies and aspirate, blood tests and faecal parasite and calprotectin tests. Recovered subjects were recruited for symptom analysis.Results. Persisting Giardia duodenalis infection was found in 40 patients (32.3%). Duodenal biopsies showed signs of inflammation in 57 patients (47.1%). Microscopic duodenal inflammation was present in 34 (87.2%) of the Giardia positive and 23 (28.0%) of the Giardia negative patients. There were significant associations between persistent Giardia positivity, microscopic duodenal inflammation and a positive calprotectin test. Duodenal aspirate and duodenal biopsies performed poorly in diagnosis of persistent giardiasis.Conclusions: In patients with persisting symptoms after metronidazole treated Giardia infection we commonly found chronic Giardia infection and microscopic duodenal. inflammation, especially in illness duration less than 7 months. Both these findings subsided over time. Increasingly, investigations could not determine a definite cause for the persistent symptoms. The very tong-term post-giardiasis diarrhoea, bloating, nausea and abdominal pain documented here need further study. (c) 2007 The British Infection Society. Published by Elsevier Ltd. All rights reserved.