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Epidemiological and clinical characteristics of Dientamoeba fragilis infection.

Authors
  • Menéndez, Candela1
  • Fernández-Suarez, Jonathan2
  • Boga Ribeiro, Jose A2
  • Rodríguez-Pérez, Mercedes2
  • Vázquez, Fernando2
  • Gonzalez-Sotorrios, Nieves3
  • Rodríguez-Guardado, Azucena4
  • 1 Internal Medicine Unit, Hospital Universitario Central de Asturias, Oviedo, Spain. , (Spain)
  • 2 Microbiology Unit, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Oviedo, Spain. , (Spain)
  • 3 Gastrointestinal Diseases Unit, Hospital Universitario Central de Asturias, Oviedo, Spain. , (Spain)
  • 4 Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain. Electronic address: [email protected] , (Spain)
Type
Published Article
Journal
Enfermedades Infecciosas y Microbiología Clínica
Publisher
Elsevier
Publication Date
May 01, 2019
Volume
37
Issue
5
Pages
290–295
Identifiers
DOI: 10.1016/j.eimc.2018.07.008
PMID: 30274823
Source
Medline
Keywords
Language
Spanish
License
Unknown

Abstract

The characteristics of D. fragilis infection are described, with special focus on the clinical and epidemiological aspects. A retrospective and descriptive study was performed, including all the patients with Dientamoeba fragilis infection who attended a specialized unit between January 2012 and December 2017. PCR was used to diagnose D. fragilis. Patients were treated with metronidazole or paromomycin and reviewed at four and eight weeks post-treatment. Cure was defined as the negativization of all parasitological tests, in absence of symptoms. 163 patients were diagnosed. The most frequent symptoms were abdominal pain (36.2%), chronic diarrhoea (12.3%), anal itching (10.4%), abdominal discomfort (9.2%), skin disease (8%), acute diarrhoea (4.3%) and vomiting (4.3%). Fifty patients were asymptomatic. Forty-two patients had eosinophilia in blood. Thirty-eight cases (23.3%) had a coinfection by Enterobius vermicularis. One hundred and seven patients received treatment, sixty-one of them with metronidazole and the rest with paromomycin. Ninety-nine patients (91%) were cured. The rate of cure was 100% in the paromomycin group versus 86.8% in the metronidazole group (p=0.005; OR: 1.173 [1.057-1.302]). The absence of cure was associated with E. vermicularis coinfection (p=0.014; OR: 6.167 [1.432-26.563] and with longer duration of the symptoms (175 [±159SD]) versus 84 [±88SD] days, p=0.014) but multivariable analysis did not confirm these associations. Dientamoeba fragilis is an important and underestimated cause of gastrointestinal disease in both the autochthonous and immigrant or traveller population. More studies are needed to clarify its optimal treatment and the role played by E. vermicularis in its transmission and maintenance. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

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