AMEBA AND GIARDIA INFECTIONS NLM AIDSLINE Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.

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AMEBA AND GIARDIA INFECTIONS

Infect Dis Ther; 3:379-97 1989. Unique Identifier : AIDSLINE ICDB/90665455
Petersen C; Div. of Infectious Diseases, Dept. of Medicine, Univ. of; California and San Francisco General Hosp., San Francisco, CA

Abstract: Sexual transmission of enteric protozoa among homosexual men was reported in 1967 in New York City. Since then, an epidemic of amebiasis and giardiasis has been amply documented in this population. A similar epidemic has not occurred in other AIDS risk groups. The prevalence of enteric infection in homosexual men has been correlated with a history of oral-anal contact and multiple sex partners. Protozoan infections in patients (pts) with AIDS are reviewed, including amebiasis and giardiasis (pathophysiology, clinical presentation, diagnosis, and treatment), and other protozoans (Balantidium coli, Dientamoeba fragilis, Blastocystis hominis, Entamoeba spp., Endolimax nana, and Iodamoeba buetschlii). Entamoeba histolytica and Giardia lamblia exist in two stages in the host, the motile and infectious trophozoite and the environmentally resistant cyst. The cyst is ingested, excysts in the upper gastrointestinal tract, and forms trophozoites. Trophozoites of giardia localize mainly in the duodenum and upper small intestine, whereas those of ameba localize in the colon. In considering enteric protozoal infection in pts with AIDS and homosexual men, as well as in the general population, three points must be considered: (1) pathogenic protozoa do not always produce symptoms in infected persons, (2) asymptomatic persons may serve as reservoirs for protozoal infection, and (3) finding a pathogenic protozoan is not proof that it is causing the pt's symptoms. Because of the inability to rule out pathogenic protozoan disease definitively in pts with AIDS with diarrhea and parasites of only low or unreported pathogenicity in their stool, some physicians empirically treat these pts with a course of antiparasitic drugs (eg, metronidazole or quinacrine). Unpublished experience at San Francisco General Hospital indicates that such therapy rarely results in an improvement in symptoms or signs, perhaps because these pts are suffering from diarrhea caused by HIV or as yet unrecognized pathogens. (110 Refs)
Keywords: Acquired Immunodeficiency Syndrome/DIAGNOSIS Antiprotozoal Agents/THERAPEUTIC USE Diagnosis, Differential Entamoebiasis/*COMPLICATIONS/DIAGNOSIS/DRUG THERAPY Giardiasis/*COMPLICATIONS/DIAGNOSIS/DRUG THERAPY Human Opportunistic Infections/*COMPLICATIONS/DIAGNOSIS/DRUG THERAPY JOURNAL ARTICLE REVIEW REVIEW, TUTORIALKWDacquiredimmunodeficiencysyndrome/diagnosisantiprotozoalagents/therapeuticusediagnosis,differentialentamoebiasis/KWDcomplications/diagnosis/drugtherapygiardiasis/KWDcomplications/diagnosis/drugtherapyhumanopportunisticinfections/KWDcomplications/diagnosis/drugtherapyjournalarticlereviewreview,tutorial
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Copyright © 1990 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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