Dientameoba fragilis

Dientamoeba fragilis infectionDientamoeba Description, Causes and Risk Factors: Def: A species of small ameba-like flagellates, formerly considered a true ameba, now recognized as an ameboflagellate related to trichomonas, parasitic in the large intestine of humans and certain monkeys; may be nonpathogenic, but believed to be capable of sometimes causing low-grade inflammation with mucous diarrhea and gastrointestinal disturbance in humans. The life cycle is not known. Dientamoeba fragilis is an infection which occurs very rarely in humans. It is not an ameba but a flagellate. This protozoan parasite produces trophozoites which is a cysts have not been identified. Infection may be either symptomatic or asymptomatic. The trophozoites are generally between 9-15 m in diameter and contain one or two nuclei. The nuclear chromatin is usually fragmented. There is no cyst stage. D. fragilis are best detected in permanent -stained fecal smears. The complete life cycle of this parasite has not yet been determined, but assumptions were made based on clinical data. To date, the cyst stage has not been identified in D. fragilis life cycle, and the trophozoite is the only stage found in stools of infected individuals. A small ameba that is parasitic in the large intestine and is capable of causing low-grade inflammation coupled with mucous diarrhea and gastrointestinal disturbance. Though Dientamoeba fragilis ability of to cause disease is still questioned by some, the circumstantial evidence incriminating this organism as a pathogen is overwhelming. People who live in institutions that have poor sanitary conditions and travelers who visit developing countries have the highest risk for the infection of Dientamoeba. It increases in conditions of crowding and poor sanitation. Rates of infection in military personnel and mental institutions are higher. The true extent of disease has yet to emerge as most laboratories do not use techniques to adequately identify this organism. An Australian study identified a large number of patients considered to have Irritable bowel syndrome who were actually infected with Dientamoeba fragilis. In the first account of Dientamoeba it was described as being far less common than E. coli, E. histolytica, or E. nana. However, recent studies described Dientamoeba as being more common than E. histolytica. Most report suggests that females are more likely to harbor Dientamoeba than males. Symptoms: Abdominal pain discomfort and diarrhea are the symptoms most often described in patients harboring Dientamoeba. Other symptoms may include fecal urgency, vomiting, nausea, anorexia, weight loss, and fever. Diagnosis: Diagnosis is dependent on examination of the fresh direct wet preparation or permanently stained smears prepared from unformed or formed stools with mucus. It is particularly important that permanent stained smears of stool preparations should be examined, because survival times of the organism in terms of morphology, is very limited and specimens must be examined immediately or preserved in a suitable fixative as soon as possible after defecation. The recommended stains are Fields' and Giemsa. The trophozoite is destroyed in a formol-ether concentrate. Treatment: For the best treatment doctor will ask you to provide stool samples for testing. Because the parasite is not always found in every stool sample, you might be asked to submit stool samples from more than one day. You might also be tested for pinworm eggs, which are commonly (but not always) found in persons infected with D. fragilis. Safe and effective drugs are available. The drug of choice is iodoquinol. Paromomycin, tetracycline, (contraindicated in children under age 8, pregnant and lactating women) or metronidazole can also be used. Metronidazole, Tetracycline and Iodoquinol are all conventional drugs that may be used in the treatment of Dientamoeba fragilis. NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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