[CIS PIDD] [cis-pidd] Boy with chronic giardiasis

[dmvascon at usp.br]

Dear Jennifer 

I agree with Thomas about metronidazole and quinacrine. You may also use metronidazole and propranolol, that detaches Giardia frome the enterocytes. 

Best, 

Dewton 

Dewton de Moraes Vasconcelos 
University of São Paulo School of Medicine 

----- Mensagem original -----


> De: "Thomas G. Boyce, M.D." <Boyce.Thomas at mayo.edu>

> Para: "CIS-PIDD" <cis-pidd at lists.clinimmsoc.org>

> Enviadas: Quinta-feira, 13 de Junho de 2013 23:32:18

> Assunto: RE:[cis-pidd] Boy with chronic giardiasis



> I have been able to clear chronic giardiasis in similar patients with

> a 21-day course of metronidazole and quinacrine administered

> together.



> From: bounce-43478669-183824398 at lists.clinimmsoc.org

> [mailto:bounce-43478669-183824398 at lists.clinimmsoc.org] On Behalf Of

> Leiding, Jennifer

> Sent: Thursday, June 13, 2013 8:46 PM

> To: CIS-PIDD

> Subject: [cis-pidd] Boy with chronic giardiasis



> Hi all:



> I am following a little 6yo boy with chronic Giardia infection

> starting at age 4. He has intermittent symptoms of abdominal pain

> and diarrhea or loose stools. He has been treated with prolonged

> courses of metronidazole, paramomycin, and Alinia without effect.

> Endoscopy and colonoscopy were normal with the exception of Giardia

> on biopsy specimens from the colonoscopy. He is thriving well and

> not losing weight. There is no history of major infections but does

> have frequent URI’s. Other parasitic infections, cryptosporidium,

> and C. diff were ruled out. Vitamin deficiencies associated with

> chronic giardiasis were also ruled out.



> He lives in an urban area and no one else in the family has been

> infected. He has an older brother who is healthy. His family had

> their water checked by the city and was normal with no parasites or

> other enteric organisms.



> CMP is normal

> CBC – normal with ALC 2700, ANC 3400 AEC 270

> Diphtheria, tetanus, pneumococcal titers normal.

> IgG 832, IgA 94, IgM 87, IgE 178

> Absolute CD3 1707, CD4 1178, CD8 418, CD56 154, CD19 518

> Normal endoscopy and colonoscopy other than Giardia found on biopsy

> slides

> Vitamin C 1.62 vitamin A 30 folate 19.4



> Does anybody have any ideas about further workup or management?



> Thanks,

> Jenny Leiding



> Jennifer Leiding, MD



> Assistant Professor



> University of South Florida



> Department of Pediatrics



> Division of Allergy, Immunology, and Rheumatology



> Children’s Research Institute



> 140 – 7 th Avenue South Box 9680



> St. Petersburg, Florida 33701



> Phone: 727.553.3519



> Fax: 727.553.1295

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