title: A review of Dientamoeba fragilis carriage in humans: several reasons why this organism should be considered in the diagnosis of gastrointestinal illness.
abstract: Dientamoeba fragilis is a protozoan that inhabits the human gut. It is approximately 100 years since Dientamoeba's discovery and first description when it was described as a rare and harmless commensal. Since then it has struggled to gain recognition as a pathogen despite the evidence supporting its pathogenicity. Dientamoeba remains neglected, probably due to the misconceptions that it is uncommon and non-pathogenic. Usually, carriage of Dientamoeba is associated with symptoms such as abdominal pain and diarrhea. Moreover, antimicrobial therapy followed by resolution of symptoms coincides with the eradication of Dientamoeba. This manuscript reviews the scientific literature relating to Dientamoeba's prevalence and pathogenicity. While much of the evidence supporting its pathogenicity is only circumstantial, it is apparent that most researchers agree that Dientamoeba is pathogenic. Therefore, in symptomatic patients who harbor Dientamoeba and no other pathogen, Dientamoeba should be considered as the etiological agent and treated as such.
authors.affiliation: Division of Microbiology, SydPath, St. Vincent's Hospital, Darlinghurst, Australia.
authors.forename: Joel L N
authors.initials: JL
authors.lastname: Barratt
authors.forename: John
authors.initials: J
authors.lastname: Harkness
authors.forename: Deborah
authors.initials: D
authors.lastname: Marriott
authors.forename: John T
authors.initials: JT
authors.lastname: Ellis
authors.forename: Damien
authors.initials: D
authors.lastname: Stark
mesh_terms: D015746:Abdominal Pain / Q000469:parasitology; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000818:Animals; D002353:Carrier State / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000469:parasitology; D004029:Dientamoeba / Q000145:classification / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D004030:Dientamoebiasis / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D041981:Gastrointestinal Tract / Q000469:parasitology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007411:Intestinal Diseases, Parasitic / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D008875:Middle Aged; D015995:Prevalence; D017678:Sex Distribution; D055815:Young Adult