Ocular ischemic syndrome
The incidence ocular ischemic syndrome reactive arthritis and cutaneous symptoms in patients with giardiasis with simultaneous characte risticbiliary and gastrointestinal manifestation was investigated. In the majority of cases, parasitic infection was detected from fresh warm bile or, in a smaller proportion of patients, from fresh stool.
Nine patients presented with reactive arthritis, 59 with chronic urticaria, 17 with rosacea, 8 with prurigo nodularis, and 2 with erythema nodosum. In all cases, initial therapy consisted of metroni dazol Klionusing a daily dose of 0.
Only those patients whose symptoms were eliminated or substantially diminished and whose duodenal aspirate and stool was devoid of the parasite one month following treatment were ocular ischemic syndrome cured. Sixty seven patients remained Giardia positive after metronidazol treatment.
A detailed description of the curative therapeutic combinations in the cases of 64 patients is presented in the paper. Despite repetitive and combination therapy, three patients remained Giardia positive and continued to present with the symptoms of the parasitic disease.
The authors emphasize that in patients having cutaneous allergic symptoms, reactive arthritis, or erythema nodosum with simultaneous gastrointestinal symptoms even of the gastroin testinal symptoms are mild or absentbiliary or gastrointestinal Giardia infection must be considered.