Korean J Med.  2015 Sep;89(3):312-316. 10.3904/kjm.2015.89.3.312.

A Case of Colitis by Giardia lamblia Infection with Atypical Presentation

Affiliations
  • 1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. yscho@catholic.ac.kr
  • 2Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Abstract

Giardia lamblia infection, giardiasis, is the leading waterborne diarrhea-causing disease. It is common in most countries of the world, including South Korea and Japan. Giardia lamblia can cause asymptomatic infection but also acute abdominal discomfort with diarrhea. In addition, it may lead to chronic diarrhea associated with villous atrophy and impaired epithelial barrier in the small intestine. In the present case, a 45-year-old woman presented with lower abdominal discomfort in the absence of diarrhea. Colonoscopy showed diffuse mucosal edema, erythema, and erosions with exudate in the cecum and ascending colon. Colonoscopic biopsy and stool examination revealed trophozoites of Giardia lamblia. Colitis resolved after metronidazole therapy. Our case suggests that giardiasis should be included in the differential diagnosis of colitis, even if the patient does not present with diarrhea.

Keyword

Giardia lamblia; Colitis; Trophozoites; Metronidazole

MeSH Terms

Asymptomatic Infections
Atrophy
Biopsy
Cecum
Colitis*
Colon, Ascending
Colonoscopy
Diagnosis, Differential
Diarrhea
Edema
Erythema
Exudates and Transudates
Female
Giardia lamblia*
Giardia*
Giardiasis
Humans
Intestine, Small
Japan
Korea
Metronidazole
Middle Aged
Trophozoites
Metronidazole
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