DUODENAL VILLOUS ATROPHY AND MALABSORPTIO N IN A HUMAN INFECTED WITH GIARDIA-LAMBLIA

A 35-year-old German woman presented after a three month journey to Su dan with intermittent, persistent watery diarrhea. Stool examination i dentified giardia lamblia. The patient was unsuccessfully orally treat ed with metronidazol 250 mg three times a day for seven days and tinid azol 2 g as single dose. During a two week hospitalization we observed a total villous atrophy in a duodenal biopsy specimen in absence of c eliac sprue or a immunodeficiency syndrome. We treated with metronidaz ol 500 mg three times a day intravenously and discharged the patient i n good condition. This case report shows the variability of clinical p resentation of infection with giardia lamblia. Moreover, we demonstrat e rarely found histological changes as reason for clinical presentatio n, unsuccessful oral treatment and malabsorption. The intravenous ther apy lead to a permanent eradication of giardia lamblia.