Giardiasi (Giardia lamblia)
Definizione
La giardiasi è un’ infezione dovuta al protozoo flagellato “Giardia lamblia”, diffusa in tutto il mondo e frequentemente causa di malattia diarroica. E’ la parassitosi più spesso causa di malassorbimento e la sua maggiore prevalenza è stata dimostrata in età pediatrica. Il ciclo vitale del parassita comprende due forme distinte: le cisti e i trofozoiti. Nell’uomo, le prime vengono introdotte con acqua e cibi contaminati, giungono nello stomaco dove si trasformano in trofozoiti, quindi passano nell’intestino tenue, dove si moltiplicano e aderiscono gli enterociti.
Eziologia
L’agente patogeno è un protozoo flagellato, “Giardia lamblia“, che si localizza e si riproduce nell’intestino; il suo potere patogeno è scarso e deve proliferare in gran numero per provocare manifestazioni cliniche. La giardiasi è contratta dall’ingestione di acqua e alimenti crudi contaminati da cisti provenienti dalle feci di un malato o di un portatore sano. L’infezione è grave in caso di immunodepressione.
Epidemiologia
La giardiasi è una malattia diffusa nel mondo intero ovunque le condizioni d’igiene siano insufficienti ed epidemie possono essere causate dalla contaminazione dell’acqua potabile. Nei paesi industrializzati circa il 2% degli adulti e il 6% dei bambini risultano infetti.
Sintomi
La maggior parte delle infezioni decorre in maniera asintomatica; negli altri casi dopo un periodo di incubazione che varia da uno a tre settimane, compare la diarrea con feci schiumose e ricche di grassi, dolori epigastrici, anoressia, nausea, meteorismo e sindrome da malassorbimento.
Prognosi
La prognosi delle giardiasi è in genere molto favorevole.
Terapia
I farmaci di scelta sono i derivati imidazolici somministrati per via orale: tinidazolo in un’unica dose o nitazoxanide per 3 giorni o metronidazolo per 7 giorni.
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