Diarrhées parasitaires de l'enfant

In many areas, Entamoeba histolytica and Entamoeba dispar are found together and their microscopic appearance is identical. Biochemical tests which can show cell wall differences are often falsely negative and the only possible way is to treat with metronidazole when amoebiasis is suspected. In case of clinical failure of metronidazole, a bacterial diarrhea is frequently found. Giardia is an other protozoa frequently found in stools of children in endemic areas. Diarrheas due to Giardia are possible in normal children and frequent in malnourished. They can determine severe atrophy of jejunal mucosa and must be treated. Cryptoridiosis is frequently asymptomatic but induces diarrhea in malnourished children. Diarrhea due to helminths is rare and only Strongyloides stercoralis induces severe diarrhea in malnourished child and must be treated in emergency with Ivermectin to avoid dissemination. In immune deficiency induced by corticosteroid treatment or cancer chemotherapy, a prophylactic treatment with Ivermectin against Strongyloides stercoralis must be given in endemic areas or after return, and probably also with metronidazole against Giardia.