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Stomach

Gastric Giardiasis

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 19 October 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Caused by Giardia lamblia
● Often associated with H. pylori infection (J Clin Pathol 1992;45:964)
● Very rarely reported in the stomach, overwhelming majority detected in small intestine (See Small Bowel topic)

Clinical
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● Severe diarrhea, vomiting, abdominal cramps, fever
● Also anorexia, malaise, fatigue
● Associated with chronic atrophic gastritis (J Egypt Soc Parasitol 1996;26:481)
● Recommended to search carefully for giardia in patients with chronic atrophic gastritis, as it may cause persistent upper GI symptoms even after H. pylori eradication (Indian J Pathol Med 2006;49:519)

Case reports
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● 20 year old woman with dyspepsia (Case of the Week #157)

Treatment
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● Metronidazole or other antibiotics (eMedicine)

Micro description
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● Trophozoites are sickle or teardrop shaped and can be found along the surface of the foveolar epithelial cells

Micro images
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Giardial trophozoites along the surface of foveolar epithelial cells


Sickle-shaped trophozoites


Small intestinal giardia


Pear-shaped trophozoites from stool

Positive stains
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● Trichrome with iron-hematoxylin counterstain
● Giemsa stain

Videos
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"Falling leaf" motion of trophozoite, contributed by Dr. Shrinivasan Chamarajan

Differential diagnosis
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● H. pylori associated follicular gastritis

End of Stomach > Gastric Giardiasis

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