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A Review of the Clinical Presentation of Dientamoebiasis

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  • 1 St. Vincent's Hospital, Division of Microbiology, Sydney, Australia; University of Technology Sydney, Department of Medical and Molecular Biosciences, Broadway, Australia

Among 750 symptomatic and asymptomatic patients, Dientamoeba fragilis was detected at a prevalence of 5.2% and more common than Giardia intestinalis. 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 D. fragilis 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 Enterobius vermicularis, a proposed vector of transmission, were detected. Intermittent shedding of D. fragilis was found to be highly variable. These studies confirm the pathogenic nature of D. fragilis and we recommend laboratories routinely test for the organism.

Author Notes

*Address correspondence to Damien Stark, Department of Microbiology, St. Vincent's Hospital, Darlinghurst 2010, NSW, Australia. E-mail: dstark@stvincents.com.au

Authors' addresses: Damien Stark, Department of Microbiology, St. Vincent's Hospital, Darlinghurst, NSW, Australia, E-mail: dstark@stvincents.com.au. Joel Barratt, St. Vincent's Hospital, Division of Microbiology, Sydney, Australia, University of Technology Sydney, Department of Medical and Molecular Biosciences, Broadway, Australia, E-mail: Joel.Barratt-1@uts.edu.au. Tamalee Roberts, St. Vincent's Hospital, Division of Microbiology, Sydney, Australia, E-mail: troberts@stvincents.com.au. Deborah Marriott, St. Vincent's Hospital, Division of Microbiology, Sydney, Australia, University of Technology Sydney, Department of Medical and Molecular Biosciences, Broadway, Australia, E-mail: dmarriott@stvincents.com.au. John Harkness, St. Vincent's Hospital, Division of Microbiology, Sydney, Australia, University of Technology Sydney, Department of Medical and Molecular Biosciences, Broadway, Australia, E-mail: jharkness@stvincents.com.au. John Ellis, University of Technology Sydney, Department of Medical and Molecular Biosciences, Broadway, Australia, E-mail: john.ellis@uts.edu.au.

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