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Dientamoeba fragilis. An intestinal pathogen in children?
Insights
Dientamoeba fragilis is a pathogenic cause of gastrointestinal symptoms in children, including diarrhea and abdominal pain. Treatment with diiodohydroxyquin or metronidazole effectively resolved symptoms in a study of 35 children.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Parasitology
Background:
- Dientamoeba fragilis is a protozoan parasite that infects the human gastrointestinal tract.
- Its role in causing symptoms in children has been debated.
- This study investigates the pathogenicity of D. fragilis in pediatric patients.
Purpose of the Study:
- To determine if Dientamoeba fragilis is a significant cause of gastrointestinal symptoms in children.
- To evaluate the association between D. fragilis infection and symptoms like diarrhea and abdominal pain.
- To assess the efficacy of common treatments for D. fragilis infections.
Main Methods:
- A retrospective study of 35 children with Dientamoeba fragilis as the sole identified gastrointestinal parasite.
- Analysis of presenting gastrointestinal symptoms (diarrhea, abdominal pain).
- Evaluation of peripheral eosinophilia and treatment outcomes with diiodohydroxyquin or metronidazole.
Main Results:
- Gastrointestinal symptoms were present in 91% of the children studied.
- Diarrhea was common in acute cases; abdominal pain was more frequent in chronic cases.
- Peripheral eosinophilia was observed in 50% of infected children, significantly more than in controls.
- Treatment with diiodohydroxyquin or metronidazole led to symptom resolution or improvement.
Conclusions:
- Dientamoeba fragilis should be considered a pathogenic organism in children presenting with gastrointestinal symptoms.
- The parasite is associated with symptoms such as diarrhea and abdominal pain.
- Antiparasitic therapy is effective in managing D. fragilis infections in pediatric patients.
Abstract:
A retrospective study was conducted of 35 children in whom Dientamoeba fragilis was the only parasite found in the gastrointestinal (GI) tract. Gastrointestinal symptoms were present in 32 (91%) of these children; diarrhea was the most common finding in patients with acute symptoms, whereas abdominal pain was more common in children with chronic symptoms. Peripheral eosinophilia was present in half of the children examined and was statistically more significant in patients with D fragilis than in a control group of children admitted for elective surgery. Therapy with diiodohydroxyquin or metronidazole was effective; children's symptoms were diminished or were eliminated on follow-up evaluation after treatment. From this association between therapy and symptomatic relief, D fragilis should be considered pathogenic in those children with GI symptoms.