Clinical and Epidemiological Characteristics of Patients with Dientamoeba fragilis Infection

Abstract

Dientamoeba fragilis is an intestinal protozoan, usually considered nonpathogenic. However, in the last years, there has been an attempt to clarify its possible pathogenic role. We aim to evaluate the clinical and epidemiological characteristics of D. fragilis-infected patients. Adults with D. fragilis detection in feces who attended the Vall d'Hebron University Hospital (Barcelona, Spain) were evaluated retrospectively from April 2009 to March 2014. We classified the patients in asymptomatic, symptomatic without other causes except infection of D. fragilis, and symptomatic with another cause. Among symptomatic patients, treatment response was evaluated. One hundred eight patients were included. Sixty-three percent of the patients were immigrants, 29.6% were autochthonous, and 7.4% were travelers. Forty-nine (45.3%) patients presented symptoms, and eosinophilia was observed in 26 (24.1%) patients. Overall, 59 (54.7%) patients were asymptomatic, 15 (13.8%) presented symptoms which were attributable to other causes, and 34 (31.5%) patients presented symptoms with no other causes. In this last group, 29 patients received specific treatment and 65.5% of them presented a complete resolution of the symptoms. The group of symptomatic patients with no other cause had more proportion of women, more proportion of autochthonous people, and were older compared with the group of asymptomatic patients. Dientamoeba fragilis infection should be considered as pathogenic when other causes are ruled out.

One Health Approach to Zoonotic Parasites: Molecular Detection of Intestinal Protozoans in an Urban Population of Norway Rats, Rattus norvegicus, in Barcelona, Spain

“…It is reported worldwide, causing human gastrointestinal symptoms, and it is considered the second most common intestinal protozoan after Blastocystis, with an incidence even higher than Giardia duodenalis . In Barcelona, cases have been described in immigrant patients, as well as in autochthonous citizens, and travelers [ 35 ].…”

Paromomycin is superior to metronidazole in Dientamoeba fragilis treatment

“…The pathogenic capacity of infection by D. fragilis and its clinical manifestations vary widely, from asymptomatic cases or those with mild symptoms to chronic symptoms (Damien Stark et al, 2016; Miguel et al, 2018). Despite the considerable variability in symptomatology, with mainly asymptomatic or mild clinical manifestations, its high prevalence can generate a considerable disease load, leading to the use of many healthcare resources.…”

“…Clinical presentations vary from the absence of symptoms to gastrointestinal symptomatology mainly of abdominal pain and diarrhea (Miguel et al, 2018; Damien Stark et al, 2010). Some studies have related the clinical presentation of D. fragilis with the irritable bowel syndrome (Yakoob et al, 2010) and with eosinophilic colitis (Cuffari et al, 1998).…”

Prevalence of Intestinal Parasitoses in a Non-Endemic Setting during a 10-Year Period (2011–2020): A Focus on Dientamoeba fragilis

“…Interestingly, other clinical signs such as eosinophilia, pruritus, anal pruritus, and urticaria have also been reported in association with dientamoebiasis [9][10][11][12]. In particular, even if peripheral eosinophilia is considered a common clinical sign of any parasitic disease, several case reports have highlighted its characteristic correlation with D. fragilis infections, especially in children [9,[13][14][15][16][17][18]. On the other hand, few cases of pruritus and urticaria in patients harbouring D. fragilis have been reported over the years [12,19,20].…”