1/6. dientamoeba fragilis infection presenting to the emergency department as acute appendicitis. dientamoeba fragilis is a non-enteroinvasive, protozoan parasite of the human large intestine with a worldwide prevalence. Considered for years to be a non-pathogenic organism, more recent studies suggest that up to 25% of adult hosts and up to 90% of infested children may manifest clinical disease. D. fragilis infestation has been implicated in chronic gastrointestinal syndromes characterized by protean complaints such as post-prandial abdominal pain, chronic diarrhea, flatulence, fatigue, anorexia, and weight loss. Rarely, D. fragilis infestation is the etiology of acute abdominal pain, mimicking a surgical abdomen. A case report is presented that details a patient with a 1-month history of vague abdominal complaints who presented to the Emergency Department with an apparent episode of acute appendicitis. ( info) |
2/6. dientamoeba fragilis: a bowel pathogen? Although many patients infected with dientamoeba fragilis suffer gastrointestinal symptoms, controversy still surrounds the pathogenic role of this intestinal protozoan. We describe three patients infected with D fragilis who had gastrointestinal symptoms. In the first patient symptoms resolved with therapy before the protozoan was eradicated from the stool, however in the second, symptoms persisted unabated despite clearing of the organism. In the third patient, symptoms resolution was associated with effective treatment. We discuss the life cycle, diagnosis and treatment of this organism and its role as a pathogen. ( info) |
| Clinical reports have suggested that the parasite dientamoeba fragilis may be a cause of acute and chronic colitis in children and adults. The mechanism by which this parasite produces colitis has not been determined. The clinical findings in this case report suggest that D. fragilis causes colitis through an invasive ulcerating process. ( info) |
4/6. dientamoeba fragilis: a gastrointestinal protozoan infection in adults. dientamoeba fragilis is a protozoan parasite of the large intestine of man. Individuals with infection may be asymptomatic or have gastrointestinal and systemic symptoms. We report a patient with symptomatic D. fragilis infection and negative extensive laboratory and radiological workup, with resolution of symptoms after diiodohydroxyquin therapy. No parasites were detected in three follow-up stool examinations. We then undertook retrospective study to define and describe further clinical symptoms in adults with this infection by analysis of data from medical records of 50 subjects with this parasite. ( info) |
5/6. dientamoeba fragilis. An unusual intestinal pathogen. This is a case report of a gastrointestinal infection caused by dientamoeba fragilis. It is a flagellate protozoan that is an uncommon etiology of gastrointestinal disease. Primarily characterized by diarrhea and abdominal pain, other symptoms such as flatulence, nausea, vomiting, fatigue, malaise, and weight loss occur. diagnosis is made using multiple fresh stool samples that are preserved and permanently stained looking for the typical binucleate trophozoite. Since there is a distinct association with enterobius vermicularis (possibly the mode of protozoan transmission), the human pinworm is also sought. Treatment of choice consists of diiodohydroxyquin in adults and metronidazole in children. ( info) |
6/6. dientamoeba fragilis masquerading as allergic colitis. BACKGROUND: dientamoeba fragilis is a rare cause of chronic infectious diarrhea and colitis in children. methods: review of the clinical manifestations, diagnostic methods, and clinical course of D. fragilis infection in our hospital. RESULTS: Eleven pediatric patients are discussed, seven of whom had a history of recent travel. Clinical manifestations of infectious diarrhea included anorexia, intermittent vomiting, abdominal pain, and diarrhea, ranging from 1 to 100 weeks in duration. Peripheral eosinophilia was present in seven patients. One patient with well-documented bovine protein allergy had intermittent episodes of diarrhea and abdominal pain, despite an appropriate elimination diet. Eosinophilic colitis documented by colonoscopy, was due to D. fragilis. metronidazole was effective in treating five patients, and iodoquinol was effective in treating four others. CONCLUSIONS: D. fragilis should be included in the differential diagnosis of chronic diarrhea and eosinophilic colitis. The identification of this pathogen requires clinical awareness of epidemiologic risk factors and presenting complaints, as well as the laboratory staining procedures essential to its proper identification. ( info) |