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PARASITIC INFECTIONS
Gastrointestinal parasitic infection symptoms include abdominal pain, diarrhea, dysentery, flatulence, malabsorption and symptoms of biliary obstruction.
It can be caused by protozoan parasites and helminths.
Host susceptibility factors in gastrointestinal parasitic infections are nutritional status, intercurrent disease, pregnancy, immunosuppressive drugs and presence of a malignancy.
Knowledge of the geographic distribution of parasites is helpful in the diagnosis of patients.

Diagnosis

  • Attempt to elicit a history of possible exposure, especially for helminthic infections, eg eating undercooked meat, source of drinking water, swimming in fresh water where certain parasites may be endemic
  • Knowledge of the geographic distribution of parasites is helpful in the diagnosis of patients

Physical Examination

  • Pallor
  • Hepatomegaly
  • Ascites
  • Ileus
  • Rectal prolapse

Laboratory Tests

Microscopic Exam of Stools

  • Fundamental to the diagnosis of all GI infections
    • A minimum of 3 stool specimens, examined by trained personnel using a concentration & a permanent stain technique, should be used
    • The stool exam is used to detect protozoan cysts & trophozoites, helminth ova, proglottids, larvae or adult worms
    • A fecal sample must be mixed well before examination because eggs are never uniformly distributed in feces

Other Laboratory Tests

  • The following are other tests that may be used to document a GI parasitic infection:
    • Duodenal aspirate
    • Biopsy
    • String capsule test
    • Immunofluorescent antibody test
    • Enzyme-linked immunosorbent assay (ELISA), polymerase chain reaction (PCR)
    • Cellophane tape test
    • Barium studies
  • Anemia & eosinophilia may be seen on the complete blood count (CBC)
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