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PubMed1999

[Dientamoeba fragilis: pathogenic flagellate?].

INTRODUCTION: D. fragilis is an intestinal protozoa whose pathogenic characteristics are increasingly recognized. The aim of this study is to specify the epidemiologic, biological and clinical aspects of this protozoa. MATERIAL USED AND METHODOLOGY: Survey conducted on 27,058 parasitological test of stools in parasitology-mycology laboratory of the Sfax University Hospital over a period of 5 years. RESULTS: 11,254 parasitological test of stools were positive (41.6%) of which 89.3% comprised protozoa. D. fragilis was found in 1497 cases (13.3% of the positive cases). In 65% of these cases, it was associated with other intestinal parasites in particular Blastocystis hominis (40.3%), Endolimax nanus (24%), Entamoeba coli (6%), Giardia intestinalis (5.7%) and Enterobius vermicularis (5%). Those patients having a parasitism with isolated D. fragilis were predominantly female and young subjects (< 20 years). Clinical signs included abdominal pain (88.5%), anorexia (50%), alternating diarrhoea and constipation (40.4%) and diarrhoea (21%) with mucus in 7.6%. DISCUSSION: D. fragilis is today classified in the group of flagellates and we share the opinion of the majority of the authors as to its real pathogenic capacity.

Abdominal Pain↗
PubMed2006

Irritable bowel syndrome: a review on the role of intestinal protozoa and the importance of their detection and diagnosis.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder in which abdominal pain is associated with a defect or a change in bowel habits. Gut inflammation is one of the proposed mechanisms of pathogenesis. Recent studies have described a possible role for protozoan parasites, such as Blastocystis hominis and Dientamoeba fragilis, in the etiology of IBS. Dientamoeba fragilis is known to cause IBS-like symptoms and has a propensity to cause chronic infections but its diagnosis relies on microscopy of stained smears, which many laboratories do not perform, thereby leading to the misdiagnosis of dientamoebiasis as IBS. The role of B. hominis as an etiological agent of IBS is inconclusive, due to contradictory reports and the controversial nature of B. hominis as a human pathogen. Although Entamoeba histolytica infections occur predominately in developing regions of the world, clinical diagnosis of amebiasis is often difficult because symptoms of patients with IBS may closely mimic those patients with non-dysenteric amoebic colitis. Clinical manifestations of Giardia intestinalis infection also vary from asymptomatic carriage to acute and chronic diarrhoea with abdominal pain. These IBS-like symptoms can be continuous, intermittent, sporadic or recurrent, sometimes lasting years without correct diagnosis. It is essential that all patients with IBS undergo routine parasitological investigations in order to rule out the presence of protozoan parasites as the causative agents of the clinical signs.

Animals↗
PubMed1991

Intestinal parasites: a study of human appendices.

Histological sections of 414 appendices were examined parasitologically. Enterobius vermicularis was found in 8.7%, eggs of Ascaris lumbricoides in 0.5%, trophozites of Dientamoeba fragilis in 4.8%, Endolimax nana in 2.2%, Entamoeba coli in 1% and cysts of Giardia intestinalis in 1.9% of cases. Appendicopathies associated with Enterobius were most frequent in the age group from 6 to 10 years (24.3%) and from 21 to 25 years (12.2%). Patients older than 15 years were practically women only. Dientamoeba was most frequent in the age group from 11 to 15 years (11.3%). In women D. fragilis was three times more frequent than in men. The coincidence of D. fragilis and E. vermicularis infections was 50%. No interactions were seen between the protozoans in the contents of the appendix and its mucous membrane. Statistical evaluation indicates possible etiologic role of E. vermicularis in the occurrence of acute appendicities. D. fragilis appears to be the most common intestinal protozoan parasite in Bohemia.

Adolescent↗
PubMedDate not supplied

Phylogenetic position of the trichomonad parasite of turkeys, Histomonas meleagridis (Smith) Tyzzer, inferred from small subunit rRNA sequence.

The phylogenetic position of the trichomonad, Histomonas meleagridis was determined by analysis of small subunit rRNAs. Molecular trees including all identified parabasalid sequences available in data bases were inferred by distance, parsimony, and likelihood methods. All reveal a close relationship between H. meleagridis, and Dientamoeba fragilis. Moreover, small subunit rRNAs of both amoeboid species have a reduced G + C content and increased chain length relative to other parabasalids. Finally, the rRNA genes from H. meleagridis and D. fragilis share a recent common ancestor with Tritrichomonasfoetus, which exhibits a more developed cytoskeleton. This indicates that Histomonas and Dientamoeba secondarily lost most of the typical trichomonad cytoskeletal structures and hence, do not represent primitive morphologies. A global phylogeny of parabasalids revealed significant discrepancies with morphology-based classifications, such as the polyphyly of most of the parabasalid families and classes included in our study.

Animals↗
PubMed2004

[Digestive parasitism in Sousse area. Results of a 16 years retrospective study].

To report the prevalence and type of intestinal parasites together with their kinetics in Sousse region. Our retrospective study concern data from the examination of 56,268 stool samples and 7552 tape tests, performed in the laboratory of parasitology of F. Hached Sousse hospital from 1st January 1987 up to 31 December 2002. We observed an overall parasite prevalence of 31.5%. Most common parasites were protozoa, Giardia lamblia, Dientamoeba fragilis and Blastocystis hominis being the most frequently encountered. Helminths consisted mainly of Enterobias vermicularis (35.86% positive tape tests) and Hymenolepis nanus. The kinetics data analysis showed an important decrease in the prevalence of Giardia lamblia, the other feco-oral transmitted flagellates and Hymenolepis nanus. In contrast, Dientamoeba fragilis and Blastocystis hominis prevalences increased. The prevalence of the amoeba showed a slight decrease. Intestinal parasites remain quite common in Sousse region, even though their epidemiological patterns are changing. Factors inducing these changes need to be investigated in order to plan efficient control measures.

Adolescent↗
PubMed1981

[Contribution to the knowledge of intestinal protozoa infestation in the hospital population of Barcelona (author's transl)].

This report concerns the analysis of 650 fecal samples submitted for parasitic investigation to the Microbiology Service of the Hospital de la Santa Creu i Sant Pau of Barcelona. The samples were analyzed by the technique of fixation and direct observation of Sapero and Lawless (MIFD), and with the biphasic concentration method of Blagg et al (MIFC). Intestinal protozoa were detected in 183 samples (28.2%), with a total of 232 protozoosis uncovered. The specific analysis gave the following results: Giardia lamblia, 10.9%; Dientamoeba fragilis, 7.8%; Entamoeba coli, 4.6%; Endolimax nana, 4.5%; Entamoeba hartmanni, 4.0%; Iodamoeba buetschlii, 2.9%; Entamoeba histolytica, 0.7%; Chilomastix mesnili, 0.2%; Trichomonas hominis, 0.2%. The results obtained by the two methods have been compared, observing the highest number of positive results with MIFD technique. Especial mention is made of the higher incidence of Dientamoeba fragilis in samples positive for Oxyuris further studies being needed to establish the basis for the relationship between both species of parasites.

Animals↗