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Sequencing of Bacterial Microflora in Peripheral Blood: our Experience with HIV-infected Patients
Published on: June 11, 2011
Biliary giardiasis in a patient with human immunodeficiency virus
N E Aronson1, C Cheney, V Rholl
1Infectious Disease Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
Journal of Clinical Gastroenterology
|July 27, 2001
Summary
Persistent Giardia infection caused prolonged biliary issues in an HIV-positive man, leading to cholangiopathy. Surgical removal of the gallbladder ultimately resolved symptoms and normalized liver function tests.
Area of Science:
- Gastroenterology
- Hepatology
- Infectious Diseases
Background:
- A human immunodeficiency virus (HIV)-positive individual presented with persistent gastrointestinal symptoms.
- The patient had previously been treated for Giardia enteritis with metronidazole.
Observation:
- Following metronidazole treatment, the patient experienced prolonged abdominal pain, weight loss, and abnormal liver function tests.
- Endoscopic retrograde cholangiography (ERCP) revealed dilated bile ducts and irregularities consistent with cholangiopathy.
- Giardia trophozoites and cysts were identified in bile samples via repeat ERCP, despite further metronidazole treatment.
Findings:
- Laparoscopic cholecystectomy was performed due to a thickened gallbladder wall and persistent symptoms.
- Post-cholecystectomy, the patient experienced resolution of abdominal pain and normalization of liver function tests.
- Histopathology confirmed chronic cholecystitis, with no parasites detected in the gallbladder tissue.
Implications:
- This case highlights a rare, protracted biliary complication of Giardia infection.
- It suggests that persistent parasitic infection can lead to significant structural biliary changes.
- Cholecystectomy may be a viable treatment option for refractory biliary complications secondary to Giardia infection.
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