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Angeles University Foundation

College of Nursing

In partial fulfillment for the requirements in Microbiology and Parasitology:

Definition, Illustrations, Causative Agent, Signs and Symptoms, Preventive
Measures, Management and Treatment and Nursing Reponsibilities

Delos Santos, Sophia Rose

Garcia, Catherine
Jimenez, Miguel
Lampa, Dhaynielle
Reyes, Lindt Alex

Submitted to: Mr. Angelo Mangibin

May 27, 2019

I. Brief Definition

An infection of the small bowel, giardiasis (also called enteritis and lambliasis) is
caused by the symmetrical flagellate protozoan Giardia lamblia. A mild infection may not
produce intestinal symptoms. In untreated giardiasis, symptoms wax and wane; with
treatment, recovery is complete (McMahon &Cray, 1995). Giardia infects the small
intestine of humans, especially children (Black, 2008) and is the most commonly
identified waterborne illness in the United States (Nester et al., 2007). The disease is
sometimes mistaken for viral gastroenteritis and is considered a type of traveler’s
diarrhea (Pommerville, 2013).

II. Illustrations

Figure 1 Giardia lamblia, light micrograph Figure 2 Giardia lamblia, Scanning Electron Micrograph (SEM)

III. Causative Agents

The diplomonad Giardia lamblia (also called G. lamblia or G. duodenalis) is an

ancient eukaryote that lacks a mitochondrion, and its rRNA has many bacteria-like
features. Giardia is also characterized as a flagellated protozoan shaped like a pear cut
lengthwise, with two side-by-side nuclei that resemble eyes. Transmission of G. lamblia
is usually by the fecal-oral route, especially via fecally contaminated water. Known or
suspected sources of G. lamblia include beavers, raccoons, muskrats, dogs, cats and

From: Microbiology: Principles And Explorations; Fundamentals of Microbiology; Microbiology:

Dynamics and Diversity; Microbiology: A Human Perspective

IV. Signs and Symptoms

Attachment of G. lamblia to the intestinal lumen causes superficial mucosal

invasion and destruction, inflammation and irritation. All of these destructive effects
decrease food transit time through the small intestine and result in malabsorption. Such
malabsorption produces chronic Gastrointestinal complaints – such as abdominal
cramps – and pale, loose, greasy, malodorous, and frequent stools (from 2-10 daily),
with concurrent nausea. Stools may contain mucus but not pus or blood. Acute cases of
giardiasis are marked by severe diarrhea, cramps, flatulence, and dehydration. The
asymptomatic carriers may have intermittent mild cases of diarrhea. Chronic giardiasis
may produce fatigue and weight loss in addition to these typical signs and symptoms.

From: Infectious Disorders (Professional Care Guides) (1st ed.); Fundamentals of Microbiology (10th

V. Preventive Measures

Good personal hygiene, especially handwashing, decreases the chance of

passing on the infection. Filtration of community water supplies is effective. When
hiking, the best way to make drinking water safe from giardiasis is to boil it for 1 minute.
Using a few drops per quart of water of household sodium hypochlorite bleach, tincture
of iodine, or commercial water-purifying tablets, is also effective. The disease can be
prevented in larger populations by proper water treatment.
From: Microbiology: A Human Perspective (5th ed.); Microbiology: Dynamics and Diversity (1st ed.)
VI. Management and Treatment

A commercial ELISA test is available for detection of G. lamblia antigens in fecal

material. Giardiasis responds readily to a 10-day course of metronidazole (Flagyl) or a
7-day course of quinacrine (Atabrine) and furazolidone P.O. Severe diarrhea may
require parenteral fluid replacement to prevent dehydration if oral fluid intake is

From: Microbiology: Dynamics and Diversity (1st ed.); Infectious Disorders (Professional Care
Guides) (1st ed.); Microbiology: A Human Perspective (5th ed.)

VII. Nursing Responsibilities

 Inform the patient receiving metronidazole of the expected adverse effect of this
drug: commonly headache, anorexia, and nausea, and less commonly vomiting,
diarrhea and abdominal cramps.
 Warn against drinking alcoholic beverages because these may provoke a
disulfiram-like reaction.
 If the patient is a woman, ask if she’s pregnant, because metronidazole is
contraindicated during pregnancy.
 When talking to family members and other suspected contacts, emphasize the
importance of stool examinations for G. lamblia cysts.
 Hospitalization may be required. If so, apply enteric precautions. The patient will
require a private room if he is a child or an incontinent adult. When caring for
such a patient, pay strict attention to hand washing, particularly after handling
feces. Quickly dispose of fecal material (Normal sewage systems can remove
and process infected feces adequately.)
 Teach good personal hygiene, particularly proper hand washing technique.
 To help prevent giardiasis, warn travelers to endemic areas not to drink water or
eat uncooked and unpeeled fruits or vegetables (they may have been rinsed in
contaminated water). Prophylactic drug therapy isn’t recommended. Advise
campers to purify all stream water before drinking it.
 Report endemic situations to the public health authorities.
From: Infectious Disorders (Professional Care Guides) (1st ed.)

Black, J. G. (2008). Microbiology: Principles And Explorations, International Student
Version (7th ed.). (J. Wiley, Ed.) Virginia: John Wiley & Sons, Inc. Retrieved May
24, 2019

Gilligan, P. H., Shapiro, D. S., & Miller, M. B. (2015). Cases in Medical Microbiology and
Infectious Disease (4th ed.). Washington, D.C.: American Society for
Microbiology. Retrieved May 24, 2019

McMahon, E., & Cray, J. (1995). Infectious Disorders (Professional Care Guides) (1st
ed.). (E. Weinstein, Ed.) Springhouse Corporation. Retrieved May 24, 2019

Nester, E. W., Anderson, D. G., Roberts, C. E., & Nester, M. T. (2007). Microbiology: A
Human Perspective (5th ed.). McGraw-Hill Publishing Co. Retrieved May 24,

Perry, J. J., & Staley, J. T. (1997). Microbiology: Dynamics and Diversity (1st ed.).
Harcourt College Pub. Retrieved May 24, 2019

Pommerville, J. (2013). Fundamentals of Microbiology (10th ed.). Jones & Bartlett

Learning. Retrieved May 24, 2019

Figures/Images Sources:

Figure 1:

Figure 2: