Volume 82, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Among 750 symptomatic and asymptomatic patients, was detected at a prevalence of 5.2% and more common than . Most infected patients presented with diarrhea and abdominal pain with symptoms greater than 2 weeks duration being common. Bacterial and viral causes of infection were excluded by routine microbiological techniques. Treatment of infection with either iodoquinol, paromomycin, or combination therapy resulted in the eradication of the parasite and complete resolution of symptoms. Treatment failure/relapses were associated only with the use of metronidazole. Nineteen patients were examined for pin worm, no , a proposed vector of transmission, were detected. Intermittent shedding of was found to be highly variable. These studies confirm the pathogenic nature of and we recommend laboratories routinely test for the organism.


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  1. Jepps MW, Dobell C, , 1918. Dientamoeba fragilis n.g., n. sp., new intestinal amoeba from man. Parasitology 10: 352367.[Crossref]
  2. Camp RR, Mattern CF, Honigberg BM, , 1974. Study of Dientamoeba fragilis Jepps and Dobell. I. Electronmicroscopic observations of the binucleate stages. II. Taxonomic position and revision of the genus. J Protozool 21: 6982.[Crossref]
  3. Dwyer DM, , 1974. Analysis of the antigenic relationships among Trichomonas, Histomonas, Dientamoeba and Entamoeba. 3. Immunoelectrophoresis technics. J Protozool 21: 139145.[Crossref]
  4. Silberman JD, Clark CG, Sogin ML, , 1996. Dientamoeba fragilis shares a recent common evolutionary history with the trichomonads. Mol Biochem Parasitol 76: 311314.[Crossref]
  5. Delgado-Viscogliosi P, Viscogliosi E, Gerbod D, Kulda J, Sogin ML, Edgcomb VP, , 2000. Molecular phylogeny of parabasalids based on small subunit rRNA sequences, with emphasis on the Trichomonadinae subfamily. J Eukaryot Microbiol 47: 7075.[Crossref]
  6. Vandenberg O, Peek R, Souayah H, Dediste A, Buset M, Scheen R, Retore P, Zissis G, van Gool T, , 2006. Clinical and microbiological features of dientamoebiasis in patients suspected of suffering from a parasitic gastrointestinal illness: a comparison of Dientamoeba fragilis and Giardia lamblia infections. Int J Infect Dis 10: 255261.[Crossref]
  7. Crotti D, D'Annibale ML, Fonzo G, Lalle M, Caccio SM, Pozio E, , 2005. Dientamoeba fragilis is more prevalent than Giardia duodenalis in children and adults attending a day care centre in Central Italy. Parasite 12: 165170.[Crossref]
  8. Norberg A, Nord CE, Evengard B, , 2003. Dientamoeba fragilis–a protozoal infection which may cause severe bowel distress. Clin Microbiol Infect 9: 6568.[Crossref]
  9. Stark D, Beebe N, Marriott D, Ellis J, Harkness J, , 2005. Prospective study of the prevalence, genotyping, and clinical relevance of Dientamoeba fragilis infections in an Australian population. J Clin Microbiol 43: 27182723.[Crossref]
  10. Crotti D, D'Annibale ML, , 2007. Human intestinal parasitosis: role of Dientamoeba fragilis in human infections. Ann Ig 19: 2734.
  11. Hussein EM, Al-Mohammed HI, Hussein AM, , 2009. Genetic diversity of Dientamoeba fragilis isolates of irritable bowel syndrome patients by high-resolution melting-curve (HRM) analysis. Parasitol Res 105: 1053–1060.[Crossref]
  12. Windsor JJ, Macfarlane L, , 2005. Irritable bowel syndrome: the need to exclude Dientamoeba fragilis . Am J Trop Med Hyg 72: 501.
  13. Johnson EH, Windsor JJ, Clark CG, , 2004. Emerging from obscurity: biological, clinical, and diagnostic aspects of Dientamoeba fragilis . Clin Microbiol Rev 17: 553570.[Crossref]
  14. Crotti D, D'Annibale ML, , 2007. Role of Dientamoeba fragilis in human bowel infections. Infez Med 15: 3039.
  15. Spencer MJ, Garcia LS, Chapin MR, , 1979. Dientamoeba fragilis. An intestinal pathogen in children? Am J Dis Child 133: 390393.[Crossref]
  16. Stensvold CR, Arendrup MC, Molbak K, Nielsen HV, , 2007. The prevalence of Dientamoeba fragilis in patients with suspected enteroparasitic disease in a metropolitan area in Denmark. Clin Microbiol Infect 13: 839842.[Crossref]
  17. Schuster H, Jackson BM, , 2008. Prevalence of Dientamoeba fragilis among patients consulting complimentary medicine practitioners in the British Isles. J Clin Pathol 62: 182–184.
  18. Rayan HZ, Ismail OA, El Gayar EK, , 2007. Prevalence and clinical features of Dientamoeba fragilis infections in patients suspected to have intestinal parasitic infection. J Egypt Soc Parasitol 37: 599608.
  19. Crotti D, D'Annibale ML, , 2007. Intestinal infections caused by Dientamoeba fragilis and Giardia duodenalis in our experience. Recenti Prog Med 98: 361366.
  20. Stark DJ, Beebe N, Marriott D, Ellis JT, Harkness J, , 2006. Dientamoebiasis: clinical importance and recent advances. Trends Parasitol 22: 9296.[Crossref]
  21. Windsor JJ, Macfarlane L, Hughes-Thapa G, Jones SK, Whiteside TM, , 2003. Detection of Dientamoeba fragilis by culture. Br J Biomed Sci 60: 7983.[Crossref]
  22. Sawangjaroen N, Luke R, Prociv P, , 1993. Diagnosis by faecal culture of Dientamoeba fragilis infections in Australian patients with diarrhoea. Trans R Soc Trop Med Hyg 87: 163165 [Crossref]
  23. Peek R, Reedeker FR, van Gool T, , 2004. Direct amplification and genotyping of Dientamoeba fragilis from human stool specimens. J Clin Microbiol 42: 631635.[Crossref]
  24. Stark D, Beebe N, Marriott D, Ellis J, Harkness J, , 2005. Detection of Dientamoeba fragilis in fresh stool specimens using PCR. Int J Parasitol 35: 5762.[Crossref]
  25. Stark D, Beebe N, Marriott D, Ellis J, Harkness J, , 2006. Evaluation of three diagnostic methods, including real-time PCR, for detection of Dientamoeba fragilis in stool specimens. J Clin Microbiol 44: 232235.[Crossref]
  26. Verweij JJ, Mulder B, Poell B, van Middelkoop D, Brienen EA, van Lieshout L, , 2007. Real-time PCR for the detection of Dientamoeba fragilis in fecal samples. Mol Cell Probes 21: 400404.[Crossref]
  27. Windsor JJ, Johnson EH, , 1999. Dientamoeba fragilis: the unflagellated human flagellate. Br J Biomed Sci 56: 293306.
  28. Butler WP, , 1996. Dientamoeba fragilis. An unusual intestinal pathogen. Dig Dis Sci 41: 18111813.[Crossref]
  29. Shein R, Gelb A, , 1983. Colitis due to Dientamoeba fragilis . Am J Gastroenterol 78: 634636.
  30. Preiss U, Ockert G, Bromme S, Otto A, , 1990. Dientamoeba fragilis infection, a cause of gastrointestinal symptoms in childhood. Klin Padiatr 202: 120123.[Crossref]
  31. Dardick KR, , 1983. Tetracycline treatment of Dientamoeba fragilis . Conn Med 47: 6970.
  32. Vandenberg O, Souayah H, Mouchet F, Dediste A, van Gool T, , 2007. Treatment of Dientamoeba fragilis infection with paromomycin. Pediatr Infect Dis J 26: 8890.[Crossref]
  33. Girginkardesler N, Coskun S, Cuneyt Balcioglu I, Ertan P, Ok UZ, , 2003. Dientamoeba fragilis, a neglected cause of diarrhea, successfully treated with secnidazole. Clin Microbiol Infect 9: 110113.[Crossref]
  34. Kurt O, Girginkardesler N, Balcioglu IC, Ozbilgin A, Ok UZ, , 2008. A comparison of metronidazole and single-dose ornidazole for the treatment of dientamoebiasis. Clin Microbiol Infect 14: 601604.[Crossref]
  35. Oxner RB, Paltridge GP, Chapman BA, Cook HB, Sheppard PF, , 1987. Dientamoeba fragilis: a bowel pathogen? N Z Med J 100: 6465.
  36. Windsor JJ, Johnson EH, , 1999. More laboratories should test for Dientamoeba fragilis infection. BMJ 318: 735.[Crossref]
  37. Grendon JH, DiGiacomo RF, Frost FJ, , 1995. Descriptive features of Dientamoeba fragilis infections. J Trop Med Hyg 98: 309315.
  38. Wenrich DH, , 1944. Studies on Dientamoeba fragilis (protozoa). IV. Further observations, with an outline of present-day knowledge of this species. J Parasitol 30: 322337.[Crossref]
  39. Fotedar R, Stark D, Beebe N, Marriott D, Ellis J, Harkness J, , 2007. Laboratory diagnostic techniques for Entamoeba species. Clin Microbiol Rev 20: 511532 table of contents.[Crossref]
  40. Adam RD, , 2001. Biology of Giardia lamblia . Clin Microbiol Rev 14: 447475.[Crossref]
  41. Current WL, Garcia LS, , 1991. Cryptosporidiosis. Clin Microbiol Rev 4: 325358.[Crossref]
  42. Ockert G, Schmidt T, , 1976. On the epidemiology of Dientamoeba fragilis Jepps and Dobell 1918. 4th communication: evidence of Dientamoeba fragilis in Enterobius eggs using isoelectric point determination. J Hyg Epidemiol Microbiol Immunol 20: 7681.
  43. Girginkardesler N, Kurt O, Kilimcioglu AA, Ok UZ, , 2008. Transmission of Dientamoeba fragilis: evaluation of the role of Enterobius vermicularis . Parasitol Int 57:: 7275.[Crossref]
  44. Cuffari C, Oligny L, Seidman EG, , 1998. Dientamoeba fragilis masquerading as allergic colitis. J Pediatr Gastroenterol Nutr 26: 1620.[Crossref]
  45. Preiss U, Ockert G, Broemme S, Otto A, , 1991. On the clinical importance of Dientamoeba fragilis infections in childhood. J Hyg Epidemiol Microbiol Immunol 35: 2734.
  46. Millet V, Spencer MJ, Chapin M, Stewart M, Yatabe JA, Brewer T, Garcia LS, , 1983. Dientamoeba fragilis, a protozoan parasite in adult members of a semicommunal group. Dig Dis Sci 28: 335339.[Crossref]
  47. Bosman DK, Benninga MA, van de Berg P, Kooijman GC, van Gool T, , 2004. Dientamoeba fragilis: possibly an important cause of persistent abdominal pain in children. Ned Tijdschr Geneeskd 148: 575579.
  48. van Gool T, Weijts R, Lommerse E, Mank TG, , 2003. Triple Faeces Test: an effective tool for detection of intestinal parasites in routine clinical practice. Eur J Clin Microbiol Infect Dis 22: 284290.
  49. Hiatt RA, Markell EK, Ng E, , 1995. How many stool examinations are necessary to detect pathogenic intestinal protozoa? Am J Trop Med Hyg 53: 3639.
  50. Stark D, Barratt J, Roberts T, Marriott D, Harkness J, Ellis J, , 2010. Comparison of microscopy, two xenic culture techniques, conventional and real-time PCR for the detection of Dientamoeba fragilis in clinical stool samples. Eur J Clin Microbiol Infect Dis. doi:10.1007/s10096-010-0876-4.

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  • Received : 19 Aug 2009
  • Accepted : 23 Nov 2009

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