Abstract:
Dientamoeba fragilis (D. fragilis) is an intestinal parasite frequently detected in humans with abdominal pain and diarrhoea, but it is also commonly found in asymptomatic subjects. Hence its clinical relevance is often disputed. The introduction of polymerase chain reaction (PCR) is a versatile and sensitive diagnostic technique for the detection of intestinal parasites, and in some Western world countries PCR has almost completely replaced microscopic diagnostics. PCR has however resulted in an increase in the number of D. fragilis-positive patients. The disputed pathogenic nature of this intestinal parasite and an apparent increase in the incidence of patients with positive PCR results have renewed the discussions between clinicians and microbiologists on how to deal with an infected patient. Moreover, treatment guidelines differ throughout the world which makes it difficult for clinicians to choose an optimal therapeutic regimen.AimTo summarize and discuss the current knowledge on the pathogenicity, best diagnostic approach, treatment and follow-up of children and adults infected with D. fragilis.
摘要:
脆弱的Dientamoeba(D.fragilis)是一种肠道寄生虫,在腹痛和腹泻的人类中经常发现,但它也常见于无症状的受试者。因此,其临床相关性经常引起争议。引入聚合酶链反应(PCR)是一种用于检测肠道寄生虫的通用而灵敏的诊断技术,在一些西方国家,PCR几乎完全取代了显微镜诊断。然而,PCR已经导致脆弱D.fragilis阳性患者的数量增加。这种肠道寄生虫的致病性有争议,PCR结果阳性的患者的发病率明显增加,这重新引发了临床医生和微生物学家之间关于如何处理感染患者的讨论。此外,世界各地的治疗指南各不相同,这使得临床医生很难选择最佳的治疗方案。目的总结和讨论当前关于致病性的知识,最好的诊断方法,感染D.fragilis的儿童和成人的治疗和随访。