HY Concept 511

[tommyk]

Case: You see another young patient in your clinic. This time, she also has bad diarrhea. So after a history, your medical student grabs some Immodium (anti-diarrheal). There is blood and yellow sticky "goop" from the GI, and you see WBCs on wet mount.
1) Is this a good idea to give anti diarrheals?
2) Rapid Rotavirus Antigen Testing is Negative, and so is Clostridum difficile toxin detection for possible antibiotic use..NEGATIVE. Other baceterial cultures are negative. Hmm.. you sit there wondering... But then your attending says she she CYSTS in the stool sample. What bug and drug?


A1) No, do NOT give antidiarrheals here, treat instead with oral hydration and replace and manage the electrolytes as necessary.

A2) Most commonly, this is Giardia. Treat with Metronidazole.

[Anonymous]

Wouldn't you find bloody diarrhea if it were E. histolytica and watery if it were Giardia?

[Anonymous]

I should have decribed the nature of the diarrhea better...tommy