Dientamoeba fragilis: a pathogenic flagellate?

Introduction: D. fragilis is an intestinal protozoa whose pathogenic charac teristics 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 t est of stools in parasitology-mycology laboratory of the Sfax University Ho spital over a period of 5 years. Results: 11 254 parasitological test of stools were positive (41,6%) of whi ch 89,3% comprised protozoa. D. fragilis was found in 1497 cases (13,3% of the positive cases). In 65% o f these cases, it was associated with other intestinal parasites in particu lar Blastocystis hominis (40,3%), Endolimax nanus (24%), Entamoeba coli (6% ), Giardia intestinalis (5,7%) and Enterobius vermicularis (5%). Those pati ents having a parasitism with isolated D. fragilis were predominantly femal e and young subjects (<20 years). Clinical signs included abdominal pain (8 8,5%), anorexia (50%), alternating diarrhoea and constipation (40,4%) and d iarrhoea (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 pathoge nic capacity.