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reveals mild to moderate acute and chronic inflammation of lamina propria with prominent
plasma cells along with focal vacuolization of the brush border and mild to moderate partial
villous atrophy and crypt hyperplasia.[401,491]
Giardia lamblia is the most common intestinal protozoan infection diagnosed in the
United States, and it is common in many parts of the world. It is occasionally seen in persons
with AIDS and can produce bloating, diarrhea, and malabsorption. The organisms are found
tightly adherent to the duodenal mucosa and appear either as 10 micron round to oval, pale-
staining trophozoites or as cysts that are slightly larger and darker staining with long axonemes
and curved median bodies. These organisms may be difficult to recover in stool and require
duodenal aspirate and biopsy for diagnosis.[401]
Amebiasis has been reported with increased frequency in persons infected with HIV who
live in endemic regions. In the U.S., the incidence remains low. The seroprevalence appears to
be greatest in men having sex with men. [495,496]
