Dientamoeba fragilis in children: a systematic review on diagnostic considerations and efficacy of treatment

Expert Review of Gastroenterology & Hepatology
Michael W van KalleveenFrans B Plötz

Abstract

Introduction: The presence of D. fragilis in feces is characterized by an asymptomatic carrier ship to a spectrum of gastrointestinal symptoms. However, a causal relationship remains to be elucidated. In this systematic review, we aimed to evaluate the relationship between the eradication of D. fragilis and symptoms to establish the strength of evidence that D. fragilis in symptomatic children warrants antibiotic treatment.Areas covered: This systematic review covers a challenge in daily clinical practice. Is it necessary to test for D. fragilis in children with gastrointestinal symptoms and does a positive fecal PCR test warrant treatment?Expert opinion: Testing for D. fragilis seems justified in a selection of children with persistent unexplained chronic abdominal pain and diarrhea. Treatment of D. fragilis should be withhold until other causes like celiac disease have been excluded. Both microscopic and Real Time-PCR methods (or a combination of the two) can be used for diagnosis. Paromomycin or clioquinol are antibiotics of choice based on their small spectrum of activity, fewer side effects, and better eradication rates than metronidazole. Future randomized studies, with strict inclusion criteria, appropriate diagnostic te...Continue Reading

References

Apr 1, 1979·American Journal of Diseases of Children·M J SpencerM R Chapin
Jan 27, 1998·Journal of Pediatric Gastroenterology and Nutrition·C CuffariE G Seidman
Dec 2, 2000·Journal of Clinical Microbiology·J A Johnson, C G Clark
Feb 18, 2003·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·N GirginkardeşlerU Z Ok
Apr 15, 2003·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·A NorbergB Evengård
Jul 20, 2004·Clinical Microbiology Reviews·Eugene H JohnsonC Graham Clark
Aug 10, 2005·The American Journal of Gastroenterology·Denesh K ChitkaraNicholas J Talley
Dec 29, 2005·Trends in Parasitology·Damien J StarkJohn Harkness
Feb 14, 2006·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Olivier VandenbergTom van Gool
Jan 2, 2007·The Pediatric Infectious Disease Journal·Olivier VandenbergTom van Gool
Aug 30, 2008·Journal of Pediatric Gastroenterology and Nutrition·Kari F BaberLynn S Walker
Feb 16, 2010·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·D StarkJ Ellis
Mar 30, 2010·The American Journal of Tropical Medicine and Hygiene·Damien StarkJohn Ellis
May 14, 2010·Diagnostic Microbiology and Infectious Disease·Adriana CalderaroCarlo Chezzi
Jan 7, 2011·Journal of Clinical Epidemiology·Howard BalshemGordon H Guyatt
Jan 21, 2011·Journal of Clinical Epidemiology·Gordon H GuyattHolger J Schünemann
Aug 2, 2011·Journal of Clinical Epidemiology·Gordon H GuyattUNKNOWN GRADE Working Group
Aug 2, 2011·Journal of Clinical Epidemiology·Gordon H GuyattUNKNOWN GRADE Working Group
Aug 2, 2011·Journal of Clinical Epidemiology·Gordon H GuyattHolger J Schünemann
Aug 2, 2011·Journal of Clinical Epidemiology·Gordon H GuyattUNKNOWN GRADE Working Group
Aug 16, 2011·Journal of Clinical Epidemiology·Gordon H GuyattHolger J Schünemann
Nov 30, 2012·The Pediatric Infectious Disease Journal·Janna M A Ter SchureTina E Faber
Jun 21, 2013·Journal of Pediatric Gastroenterology and Nutrition·Carolien F M GijsbersHans A Büller
Jul 23, 2013·International Journal for Parasitology·Varuni S MunasingheDamien Stark
Oct 18, 2013·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·L MaasB E van Ewijk
Dec 1, 2012·International Journal for Parasitology. Drugs and Drug Resistance·Noriyuki NagataDamien Stark
Mar 22, 2014·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Dennis RöserKåre Mølbak
Jul 24, 2014·Archives of Disease in Childhood·Marin J de JongJudith M Deckers-Kocken
Apr 8, 2016·Journal of Clinical Microbiology·Lynne S Garcia
Apr 12, 2016·Journal of Gastroenterology and Hepatology·Lucas H RijsmanJohannes G Kusters
May 14, 2016·Clinical Microbiology Reviews·Damien StarkJohn T Ellis
May 28, 2016·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·L O'Brien AndersenC R Stensvold
Mar 24, 2017·Journal of Clinical Microbiology·Pikka JokelainenChristen R Stensvold
Jul 13, 2017·Acta Tropica·Simone M Cacciò
Feb 3, 2018·European Journal of Pediatrics·Michael W Van KalleveenFrans B Plötz
Feb 7, 2018·Parasitology Research·Zing-Wae WongJoan L Robinson
Mar 28, 2018·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·J FriesenR Ignatius
May 28, 2016·Parasite Epidemiology and Control·Eman K El-GayarWael A Hassan
Sep 1, 2018·Parasitology·Rosanne Sfe van GestelJan F Monkelbaan
Oct 3, 2018·Enfermedades infecciosas y microbiología clínica·Candela MenéndezAzucena Rodríguez-Guardado
May 22, 2019·Pediatric Gastroenterology, Hepatology & Nutrition·Michael W van KalleveenFrans B Plötz
Jul 25, 2019·Euro Surveillance : Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin·Jukka-Pekka PietiläAnu Kantele
Nov 24, 2019·International Journal for Parasitology. Drugs and Drug Resistance·Ander BurgañaTomas M Perez-Porcuna

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Citations

Nov 13, 2020·The Pediatric Infectious Disease Journal·Michael W van KalleveenTim G J de Meij

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