GIARDIASIS Giardia lamblia/G. intestinalis/G. duodenalis Giardia lambliais a rarely diagnosed intestinal protozoan. Specimen from Parasitology lab - Feces : examination of wet preparations of feces and preparations is carried outpermanent smear. - Duodenal contents : duodenal lavage is performed. - Entero test : taking material from the contents of the duodenum by means ofsimple so that intestinal intubation is no longer needed. - Biopsy :usually sent to Lab.PA for routine histopathological examination. Procedure notes: 1. Even if the 3 stool specimens are not examined carefully, the organism may not be found. 2. Parasite motility in wet preparations may be difficult to see because the parasites are trapped in the mucus. 3. Every examination for parasites in feces should begin with a permanent smear, even in solid feces. 4. Duodenal drainage and/or use of capsules “Entero-test” is very helpful in finding these parasites. This parasite also has 2 stages/forms, namely: trophozoites and cysts Trophozoites: -The trophozoite is pyriform (pear-shaped), the anterior end is rounded, the tipposteriorly tapered, longest part 10–20 µm, widest 5–15 µm, thick 2–4 µm. -The dorsal surface is convex, while the ventral surface is half convex, the anterior part is slightly concave (= 'sucking disc'). -The paired nuclei, on the right and left of the median line, are ovoid in shape containing karyosomes in the form of a dense chromatin mass located centrally or in the form of chromatin granules scattered throughout the nucleoplasm, the nuclear membrane is thin and there is no accumulation of chromatin. -Has 1 pair of flagella that originate from superficial organelles, 2 pairs of lateral flagella, a pair of ventral flagella, a pair of posterior flagella. - The slightly curved banana/sausage-shaped parabasal objects are located transversely or obliquely directly behindsucking disc. Cyst: -Ovoid (oval) shape, length 8–19µm, average 11–14µm, width 7–10µm. -Ectoplasm dense, granular. -Has a thin, clear cyst wall -The flagella are pulled into the axoneme, giving the appearance of 4 pairs of curved brushes (picture of wood shavings). -Ripe cysts have 4 nuclei, which are not clearly visible on unstained preparations.