Repeated Dientamoeba fragilis Infections: A Case Report of Two Families from Sydney, Australia

Stark, Damien; Barratt, Joel; Ellis, John; Harkness, John; Marriott, Deborah

doi:10.4081/idr.2009.1280

Cited by 8 publications

(10 citation statements)

References 10 publications

(15 reference statements)

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“…Recently, it was also documented that 2 children presented with D. fragilis infection over prolonged periods (Stark et al . 2009). In that study, metronidazole was used initially, but subsequently treatment was done with paramomycin for 10 days to effect clearance of the parasite.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported that children are susceptible to infection with D. fragilis and present with clinical symptoms at higher rates than adults (Preiss et al 1991; Ayadi and Bahri, 1999; Crotti et al 2005). Consequently, D. fragilis should be considered in the differential diagnosis of gastrointestinal infections in children (Spencer et al 1979; Keystone et al 1984; Preiss et al 1990; Stark et al 2009) but it is generally ignored as a cause of disease. Clinical symptoms reported include acute and chronic diarrhoea, lower abdominal pain, nausea, flatulence and constipation (Spencer et al 1983; Cuffari et al 1998).…”

Section: Introductionmentioning

confidence: 99%

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A case-controlled study of Dientamoeba fragilis infections in children

et al. 2011

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Dientamoeba fragilis is a pathogenic protozoan parasite that is implicated as a cause of human diarrhoea. A case-controlled study was conducted to determine the clinical signs associated with D. fragilis infection in children presenting to a Sydney Hospital. Treatment options are also discussed. Stool specimens were collected from children aged 15 years or younger and analysed for the presence of D. fragilis. In total, 41 children were included in the study along with a control group. Laboratory diagnosis was performed by microscopy of permanently stained, fixed faecal smears and by real-time PCR. Gastrointestinal symptoms were present in 40/41 (98%) of these children with dientamoebiasis, with diarrhoea (71%) and abdominal pain (29%) the most common clinical signs. Chronic gastrointestinal symptoms were present in 2% of cases. The most common anti-microbial used for treatment was metronidazole (n=41), with complete resolution of symptoms and clearance of parasite occurring in 85% of cases. A treatment failure rate occurred in 15% of those treated with metronidazole. Follow-up treatment comprised of an additional course of metronidazole or iodoquinol was needed in order to achieve complete resolution of infection and symptoms in this group. This study demonstrates the pathogenic potential of D. fragilis in children and as such it is recommended that all laboratories must routinely test for this organism and treat if detected.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A case-controlled study of Dientamoeba fragilis infections in children

et al. 2011

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“…In contrast, several studies found no relationship between Dientamoeba and E. vermicularis (Kean and Malloch, 1966; Walker et al 1985; Oxner et al 1987; Cuffari et al 1998; Menghi et al 2005; Stark et al 2006, 2009 a , 2010 b ). In the study by Kean and Malloch (1966), only 2/100 patients with pure Dientamoeba infections had a history of pinworm infection.…”

Section: The Role Of Helminths In the Transmission Of Dientamoebamentioning

confidence: 96%

The ambiguous life ofDientamoeba fragilis: the need to investigate current hypotheses on transmission

et al. 2011

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Dientamoeba fragilis is an inhabitant of the human bowel and is associated with gastrointestinal illness. Despite its discovery over a century ago, the details of Dientamoeba's life cycle are unclear and its mode of transmission is unknown. Several theories exist which attempt to explain how Dientamoeba may be transmitted. One theory suggests that animals are responsible for the transmission of Dientamoeba. However, reports of Dientamoeba in animals are sporadic and most are not supported by molecular evidence. Another theory suggests that Dientamoeba may be transmitted via the ova of a helminth. Given that the closest relative of Dientamoeba is transmitted via the ova of a helminth, this theory seems plausible. It has also been suggested that Dientamoeba could be transmitted directly between humans. This theory also seems plausible given that other relatives of Dientamoeba are transmitted in this way. Despite numerous investigations, Dientamoeba's mode of transmission remains unknown. This review discusses the strengths and weaknesses of theories relating to Dientamoeba's mode of transmission and, by doing so, indicates where gaps in current knowledge exist. Where information is lacking, suggestions are made as to how future research could improve our knowledge on the life cycle of Dientamoeba.

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“…2004; Stark et al . 2006, 2009, 2010). Despite this, comparatively little information is available about the biology of this organism including genome and proteome studies.…”

Section: Discussionmentioning

confidence: 99%

“…2005 b , Lagace-Wiens et al . 2006, Stark et al 2006, 2007, 2009, 2010), more research with regards to this organism is warranted. The ability to maintain clinical isolates of Dientamoeba in culture for extended periods of time at high cell densities and, the ability to cryogenically preserve viable Dientamoeba trophozoites, would facilitate further study and analysis of this emerging pathogen.…”

Section: Introductionmentioning

confidence: 99%

Newly defined conditions for thein vitrocultivation and cryopreservation ofDientamoeba fragilis: new techniques set to fast track molecular studies on this organism

et al. 2010

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Dientamoeba fragilis is a pathogen of the human gastrointestinal tract that is a common cause of diarrhoea. A paucity of knowledge on the in vitro cultivation and cryopreservation of Dientamoeba has meant that few studies have been conducted to investigate its biology. The objective of this study was to define, for the first time, in vitro culture conditions able to support the long-term in vitro growth of Dientamoeba. Also, we aimed to define a suitable method for cryopreserving viable Dientamoeba trophozoites. A modified BD medium, TYGM-9, Loeffler's slope medium, Robinson's medium, Medium 199, Trichosel and a Tritrichomonas fetus medium were compared, using cell counts, for their ability to support the growth of D. fragilis at various temperatures and atmospheric conditions. Loeffler's slope medium supported significantly better growth compared to other media. A temperature of 42°C and a microaerophilic atmosphere were also optimum for Dientamoeba growth. To our knowledge, this is the first study to describe and compare different culture media and conditions for the growth of clinical isolates of D. fragilis. This new technology will aid the development of diagnostics for dientamoebiasis as well as facilitate large-scale sequencing projects that will fast track molecular studies on D. fragilis.

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Repeated Dientamoeba fragilis Infections: A Case Report of Two Families from Sydney, Australia

Cited by 8 publications

References 10 publications

A case-controlled study of Dientamoeba fragilis infections in children

A case-controlled study of Dientamoeba fragilis infections in children

The ambiguous life ofDientamoeba fragilis: the need to investigate current hypotheses on transmission

Newly defined conditions for thein vitrocultivation and cryopreservation ofDientamoeba fragilis: new techniques set to fast track molecular studies on this organism

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