DIENTAMOEBA FRAGILIS MASQUERADING AS ALLERGIC COLITIS

Background: Dientamoeba fragilis is a rare cause of chronic infectious diarrhea and colitis in children. Methods: Review of the clinical man ifestations, diagnostic methods, and clinical course of D. fragilis in fection in our hospital. Results: Eleven pediatric patients are discus sed, seven of whom had a history of recent travel. Clinical manifestat ions of infectious diarrhea included anorexia, intermittent vomiting, abdominal pain, and diarrhea, ranging from 1 to 100 weeks in duration. Peripheral eosinophilia was present in seven patients. One patient wi th well-documented bovine protein allergy had intermittent episodes of diarrhea and abdominal pain, despite an appropriate elimination diet. Eosinophilic colitis documented by colonoscopy, was due to D. fragili s. Metronidazole was effective in treating five patients, and iodoquin ol was effective in treating four others. Conclusions: D. fragilis sho uld be included in the differential diagnosis of chronic diarrhea and eosinophilic colitis. The identification of this pathogen requires cli nical awareness of epidemiologic risk factors and presenting complaint s, as well as the laboratory staining procedures essential to its prop er identification. (C) 1998 Lippincott-Raven Publishers.