Metronidazole Refractory Giardiasis Complicating the Management of Rhabdomyosarcoma in a Child

Giardiasis caused by Giardia duodenalis is one of the leading causes of gastroenteritis, especially in developing countries. The scenario may be further complicated by emerging metronidazole refractory cases worldwide. We present a case of a 2-year-old girl on chemotherapy for metastatic para meningeal rhabdomyosarcoma. She had a 15 day history of persistent diarrhea of foul-smelling loose stools, without fever. Light microscopy of stool wet mounts revealed cysts and trophozoites of Giardia duodenalis. The patient was managed with nitazoxanide after metronidazole proved ineffective clinically. This case highlights the importance of timely diagnosis and management of infectious diseases and rising antimicrobial resistance among parasites.