Dientamoebiasis laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]
Laboratory Findings
Stool Examination
Diagnosis is usually performed by submitting a stool sample for examination by a parasitologist in a procedure known as an Ova and Parasite (O&P) Examination.
The failure of routine O&P examination to identify Dientamoeba fragilis infection has been noted:
- One researcher investigated the phenomenon of symptomatic relapse following treatment of infection with Dientamoeba fragilis in association with its apparent disappearance from stool samples. The study found that the organism could still be detected in patients through colonoscopy or by examining stool samples taken in conjunction with a saline laxative. [1]
- A study found that trichrome staining, a traditional method for identification, had a sensitivity of 36% (9/25) when compared to stool culture. [2]
- An additional study found that the sensitivity of staining was 50% (2/4), and that the organism could be successfully cultured in stool specimens up to 12-hours old which were kept at room temperature. [3]
Researchers have noted that physicians in many countries have been slow to address infection with Dientamoeba fragilis, despite the body of clinical literature that links it with symptoms. Early microbiologists reported that the organism was not pathogenic, even though six of the seven individuals from whom they isolated it were experiencing symptoms of dysentary. Their report, published in 1918, concluded the organism was not pathogenic because it consumed bacteria in culture, but did not appear to engulf red blood cells was seen in the most well known disease causing amoeba of the time,Entamoeba histolytica. This initial report may still be contributing to the reluctance of physicians to diagnose the infection.
Shown below is a binucleate and uninucleate form of trophozoites of D. fragilis, stained with trichrome.
References
- ↑ Steinitz H, Talis B, Stein B (1970). "Entamoeba histolytica and Dientamoeba fragilis and the syndrome of chronic recurrent intestinal amoebiasis in Israel". Digestion. 3 (3): 146–53. PMID 4317789.
- ↑ Windsor JJ, Macfarlane L, Hughes-Thapa G, Jones SK, Whiteside TM (2003). "Detection of Dientamoeba fragilis by culture". Br. J. Biomed. Sci. 60 (2): 79–83. PMID 12866914.
- ↑ 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 (2): 163–5. PMID 8337717.