[Combined oral and endoscopic mepacrine therapy in therapy-resistant symptomatic giardiasis]

A case of extremely refractory infection with Giardia lamblia is described. A 28-year-old male patient with a 7-year history of mushy diarrhea and epigastric pain was repeatedly treated orally and intravenously, without success, with metronidazole, tinidazole, ornidazole, and mepacrine. The rate of success for these drugs is generally more than 90%. Only therapy with mepacrine orally in combination with intraduodenal administration, was successful. Therapeutic failure of 5-nitroimidazole derivatives is described in relation to immune deficiency syndromes and IgA deficit. None of these defects were found in this case.