Entamoeba histolytica and Dientamoeba fragilis and the Syndrome of Chronic Recurrent Intestinal Amoebiasis in Israel

Abstract

Among 1067 gastroenterologic out-patients examined in the years 1966–1968, Entamoeba histloytica (EH) and Dientamoeba fragilis (DF) alone or in combination, were found in 362. Of the 309 patients harbouring EH (alone or with DF), 163 or 53% presented the clinical syndrome of chronic recurrent intestinal amoebiasis. DF alone may be the cause of intestinal irritation necessitating anti-amoebic treatment. The two amoebas were found much more in stool specimens following a purgative than in spontaneous stool, and even better results were obtained from material taken at rectoscopy. The cultural method increases considerably the chances of detecting amoeba but the concurrent use of microscopic and culture techniques yield the best results. There has been practically no change in the incidences of chronic amoebiasis in the sampled population over the last 10 years.

A review ofDientamoeba fragiliscarriage in humans: Several reasons why this organism should be considered in the diagnosis of gastrointestinal illness

“…Sargeaunt et al 93 detected Dientamoeba in 9.6% of fecal specimens containing Entamoeba histolytica/dispar. Steinitz et al 94 recovered Dientamoeba often in association with E. histolyitca. Several studies also suggest that Dientamoeba is most likely to be recovered alongside Blastocystis hominis.…”

Susceptibility testing of Dientamoeba fragilis ATCC 30948 with iodoquinol, paromomycin, tetracycline, and metronidazole

“…Wenrich et al (21) reported that there is a higher incidence of gastrointestinal disorders among college students harboring D. fragilis than among those infected with Entamoeba histolytica. Sapero (15) found that 27.3% of the patients infected with D. fragilis had symptoms, and Steinitz et al (18) reported symptoms in 15.1% of infected individuals. In Canada, an incidence of 25% symptomatic cases was reported by Yang and Scholten (22).…”

The Treatment of Chronic Amoebic Infection with Metronidazole (Flagyl)

“…As can be seen from table II there is a marked difference in the clinical response to metronidazole treatment in patients with the clinical syndrome o f chronic recurrent intestinal amoebiasis (CRIA) [20] and persons with atypical symptoms. These results suggest clearly that the symptoms of the 2nd group were mostly not caused by the amoebae.…”

“…Chronic amoebic infection continues to be an important clinical and epidemiologic problem in Israel [20], Its treatment is frequently unsatis factory, requiring combined and repeated chemotherapy [1], The first reports of P o w e l l el al. [16,17] on the strong amoebicidal effect of metro nidazole (Flagyl) in acute am oebic dysentery and amoebic liver abscess, have been confirmed from different geographical regions, where epidemic and endemic amoebiasis is prevalent [2,3,14].…”