title: Dientamoeba fragilis infection presenting to the emergency department as acute appendicitis.
abstract: Dientamoeba fragilis is a non-enteroinvasive, protozoan parasite of the human large intestine with a worldwide prevalence. Considered for years to be a non-pathogenic organism, more recent studies suggest that up to 25% of adult hosts and up to 90% of infested children may manifest clinical disease. D. fragilis infestation has been implicated in chronic gastrointestinal syndromes characterized by protean complaints such as post-prandial abdominal pain, chronic diarrhea, flatulence, fatigue, anorexia, and weight loss. Rarely, D. fragilis infestation is the etiology of acute abdominal pain, mimicking a surgical abdomen. A case report is presented that details a patient with a 1-month history of vague abdominal complaints who presented to the Emergency Department with an apparent episode of acute appendicitis.
authors.affiliation: Department of Emergency Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Schwartz
authors.forename: Michael E
authors.initials: ME
authors.lastname: Nelson
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000293:Adolescent; D001064:Appendicitis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004030:Dientamoebiasis / Q000150:complications / Q000175:diagnosis* / Q000469:parasitology; D004636:Emergency Service, Hospital; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D011860:Radiography, Abdominal / Q000379:methods; D014057:Tomography, X-Ray Computed