Ocular changes associated with Giardia lamblia infection in children

Abstract

Background-The protozoan disease giardiasis can cause ocular complications, including "salt and pepper" retinal changes. Methods-Ophthalmic examinations were performed in 141 children (mean age 4.7 (SD 2.0) years) with active or past giardiasis diagnosed on the basis of microscopic examination of stool specimens or duodenal secretions-53 were newly diagnosed and untreated (group A), 50 had active infections in spite of metronidazole therapy (group B), and 38 had been successfully treated, with negative stool specimens for 1-3 years (group C). 300 children with no evidence of giardiasis were used as controls. Results-Salt and pepper retinal changes (with normal electroretinographic findings) were diagnosed in 28 (19.9%) of the patients with giardiasis (11 from group A, 10 from group B, and seven from group C), including five pairs of siblings. In all subgroups, the children with retinal changes were consistently younger than those with normal retinas. In eight cases, the lesions could be visualised only with direct ophthalmoscopy. Conclusion-Our findings indicate that asymptomatic, non-progressive retinal lesions are particularly common in younger children with giardiasis. This risk does not seem to be related to the severity of the infection, its duration, or the use of metronidazole but may reflect a genetic predisposition. (Br J Ophthalmol 1998;82:59-62)

Detection rates of waterborne protozoa in water sources from Fayoum Governorate

“…Cryptosporidiosis is a major cause of acute diarrhea in children and chronic persistent diarrhea in HIV infected individuals with low CD4 counts [3] . G. lamblia causes large numbers of gastrointestinal infections worldwide with complications that include steatorrhea, malabsorption and growth retardation in children [4,5] . Pathogenic and opportunistic FLA are aerobic eukaryotic protists that can potentially cause infections in humans and animals [6] .…”

Fungal and Parasitic Infections of the Eye

“…Retinal changes have been described as "salt and pepper" changes (55). Diagnosing ocular giardiasis is a challenge and is generally made by exclu- Rhinosporidiosis.…”

Ungewöhnliche Ursache einer chronischen Konjunktivitis

“…In Assoziation zur Giardiasis können neben Urtikaria [1,2] okuläre Entzündun-gen auftreten, z. B. Chorioretinitis und Uveitis sowie "Salz-und-Pfeffer"-artige Veränderungen der Retina [2,3,5].…”

“…B. Chorioretinitis und Uveitis sowie "Salz-und-Pfeffer"-artige Veränderungen der Retina [2,3,5]. Diese Symptome sind vermutlich allergisch bedingt; die Pathogenese ist noch unbekannt [3,5].…”

“…Retinale Veränderungen bestanden bei dem vorgestellten Patienten nicht. Von anderen Autoren wird vermutet, dass zirkulierende Immunkomplexe ursächlich sind [2]. Möglicherweise treten die beschriebenen "Salz-und-Pfeffer-artigen" Läsionen, die vermutlich auf Defekten oder einer Nekrose des retinalen Pigmentepithels beruhen, bei jüngeren Kindern häufiger auf, da hier das retinale Pigmentepithel noch nicht vollständig ausgereift ist [2].…”