{"ops":[{"insert":"A 35 year old man presents with watery diarrhea and nausea for 4 weeks.\n\nDuring this time, his bowel movements changed from once a day to 4 to 6 times a day with foul smelling, loose, urgent stools associated with a crampy abdominal pain.\n\nHe had lost 8 kg of weight during the same time period.\n\nThe symptoms started around 1 week after returning from a holiday to Turkey, where he had gone camping and drunk water from a natural spring.\n\nHis medical and surgical histories are unremarkable but his family history is significant for a sister with celiac disease.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-138_en.png"}},{"insert":"\n"}]}
2
Investigate
Stool Microscopy
{"ops":[{"insert":"Fresh stool examination for leucocytes, erythrocytes and trophozoites is negative.\nFixed stool examination for enteric parasites is negative. \nRoutine stool examination for enteric parasites is negative.\n"}]}
Stool Culture and Antigen Assay
{"ops":[{"insert":"Positive for Giardia.\nNegative for routine bacteria, rotavirus\/adenovirus antigen and Clostridium difficile antigen.\nThe Cryptosporidium antigen is not detected by a Lateral Flow Test (LFT).\n"}]}