A case of a child with four parasites in Bulgaria.

Children are more susceptible to intestinal parasitic diseases than adults due to their lack of hygiene habits and close social interactions with their peers. We present a case of a 5-year-old boy with diarrhea and abdominal pain. The stool sample and perianal swab were examined in LINA laboratory, Burgas, Bulgaria. We detected four parasites Giardia (Lamblia) intestinalis, Blastocystis hominis, Hymenolepis nana and Entamoeba coli. Microbiological stool examination shows negative results for Candida spp., Salmonella spp. and Shigella spp. Patient's peripheral blood tests were normal. The calprotectin in faeces was tested establishing slightly increased values. The presence of four parasites in one patient in Bulgaria (in the 21st century) is a rare case. Lambliosis and hymenolepiosis are more likely to be found in this patient's region. Following the presence of Entamoeba coli and the transmission mechanism of the other three parasites it can be concluded that the child's hygiene is poor. This patient reveals typical clinical picture with mild symptoms and normal paraclinical results. The presence of parasites in a definitive host is not necessarily related with the development of pathological departures. The fight with parasitic diseases can be successful with a broad integral approach - recognizing and diagnosing the parasites promptly and using radical and suitable treatment.