Key result
Trimethoprim-sulfamethoxazole and metronidazole resolve pain and yield 10 kg weight gain in a Whipple's-Giardia case.
Why the study?
The association between Whipple's disease and Giardia lamblia infection has been observed but the underlying reason remains unclear.
Case Report (n=1)
This case report highlights a rare coinfection of Whipple's disease and Giardia lamblia, contributing to the ongoing discussion about their potential association.
Answers are grounded in this paper and cite their sources.
Single case precludes practice change; leaves open potential Whipple's-giardiasis association.
Whipple' disease is mainly characterized by affecting the digestive system, although it can be a multisystemic process with different clinical symptoms. The bacillus causing the disease has been isolated and cultivated in 2000 and the genome sequence has been recently analyzed in 2003, which means new perspectives for its diagnosis and treatment. Giardiasis is an infestation caused by a protozoo and may cause a malabsorption syndrome or run in a subclinic way. The case of a middle-aged male is described, who after a three-year period of migratory arthralgias, showed weight loss, diarrheas and abdominal pain, being diagnosed of Giardiasis, and after the persistent symptoms and a number of studies, was diagnosed with Whipple disease. Nineteen cases of Giardia-Whipple coinfection have been described in the literature, but the reason of this association has not been found yet. The discussion on whether there is an alteration in the immunitary system which facilitates infections or, the development of an infection lead to the other one, goes on.
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Ruiz et al. (2005) conducted a case report in Whipple's disease and Giardia lamblia infection (n=1). Trimethoprim-sulfamethoxazole and metronidazole was evaluated on Clinical improvement. Treatment with trimethoprim-sulfamethoxazole and metronidazole led to the resolution of abdominal pain and a 10 kg weight gain within four months in a patient with concurrent Whipple's disease and Giardia lamblia infection.
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