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Abstract

Our objective was to examine the diagnostic yield of duodenal aspirates for Giardia in children and compare it to results of duodenal mucosal biopsies. The results of all duodenal aspirates submitted for direct parasite examinations over a 31-month period were reviewed, as were the histological results of duodenal mucosal biopsies from these patients. In all, 161 children (89 boys; age range 0.33-18 years) were included in the study. Giardia was identified in the duodenal aspirate of 5.6% (9/161) patients and on duodenal mucosal biopsies from all nine patients. In conclusion, the 5.6% diagnostic yield of duodenal aspirates for Giardia is higher than reported in a previous study of adult patients from a similar geographical region (0.7%). The detection of Giardia on duodenal mucosal biopsies from all patients with positive duodenal aspirates brings into question the utility and cost of the latter test. Duodenal aspirates for Giardia may be unnecessary if duodenal mucosal biopsies are obtained for histological examination.

Intestinal pseudo-obstruction caused byGiardia lambliainfection

“…In line with this observation, 18% of false negatives were reported in a retrospective histological analysis of duodenal samples from 567 cases of giardiasis presenting with celiac-like duodenal histology 35. In this context, the microscopic analysis of duodenal aspirate might have represented another diagnostic option, although not superior to the analysis of duodenal biopsies when available 36…”

“…35 In this context, the microscopic analysis of duodenal aspirate might have represented another diagnostic option, although not superior to the analysis of duodenal biopsies when available. 36 Abdominal ultrasound with intestinal assessment showed the presence of transient small bowel intussusception that was not confirmed at CT enterography. The transient nature of small bowel intussusception was previously reported in an observational study of 25 paediatric patients, none of whom had persistent intussusception requiring surgery.…”

“… 35 In this context, the microscopic analysis of duodenal aspirate might have represented another diagnostic option, although not superior to the analysis of duodenal biopsies when available. 36 …”

Incidental Diagnosis of Duodenal Giardiasis

“…However, the duodenal aspirate examination can be foregone as biopsies were found to have a better detection rate than aspirate microscopic examination [ 8 ]. In contrast, a prospective study done in 2003 showed no difference between duodenal biopsy and duodenal aspirate in detection of giardial infection; however, a recommendation of biopsy usage was made due to cost [ 10 ].…”

Giardia lamblia miRNAs as a new diagnostic tool for human giardiasis

“…Some studies have shown superiority of duodenal aspirate samples over duodenal mucosal biopsy [43]. Others showed that duodenal mucosal biopsies were more sensitive compared to duodenal aspirate samples [44].…”