[Dientamoeba fragilis: pathogenic flagellate?].

INTRODUCTION

D. fragilis is an intestinal protozoa whose pathogenic characteristics are increasingly recognized. The aim of this study is to specify the epidemiologic, biological and clinical aspects of this protozoa. MATERIAL USED AND METHODOLOGY: Survey conducted on 27,058 parasitological test of stools in parasitology-mycology laboratory of the Sfax University Hospital over a period of 5 years.

RESULTS

11,254 parasitological test of stools were positive (41.6%) of which 89.3% comprised protozoa. D. fragilis was found in 1497 cases (13.3% of the positive cases). In 65% of these cases, it was associated with other intestinal parasites in particular Blastocystis hominis (40.3%), Endolimax nanus (24%), Entamoeba coli (6%), Giardia intestinalis (5.7%) and Enterobius vermicularis (5%). Those patients having a parasitism with isolated D. fragilis were predominantly female and young subjects (< 20 years). Clinical signs included abdominal pain (88.5%), anorexia (50%), alternating diarrhoea and constipation (40.4%) and diarrhoea (21%) with mucus in 7.6%.

DISCUSSION: D. fragilis is today classified in the group of flagellates and we share the opinion of the majority of the authors as to its real pathogenic capacity.