Dientamoeba fragilis

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Dientamoeba fragilis
Dientamoeba fragilis (3027773918).jpg
Scientific classification
Domain:
(unranked):
Phylum:
Class:
Order:
Family:
Genus:
Dientamoeba
Species:
D. fragilis
Binomial name
Dientamoeba fragilis
Jeeps et Dobell, 1918

Dientamoeba fragilis is a species of single-celled excavates found in the gastrointestinal tract of some humans, pigs and gorillas. It causes gastrointestinal upset in some people, but not in others. [1] It is an important cause of travellers diarrhoea, chronic diarrhoea, fatigue and, in children, failure to thrive. Despite this, its role as a "commensal, pathobiont, or pathogen" is still debated. [2] D. fragilis is one of the smaller parasites that are able to live in the human intestine. Dientamoeba fragilis cells are able to survive and move in fresh feces but are sensitive to aerobic environments. They dissociate when in contact or placed in saline, tap water or distilled water. [3]

Contents

Etymology

It was first described in 1918. [4]

Dientamoebiasis

There is a continuous debate whether D. fragilis is considered to be a harmless organism or a pathogenic parasite. [5] Infection with D. fragilis, called dientamoebiasis, is associated variously with symptoms of abdominal pain, diarrhea, weight loss, nausea, fatigue and fever. In one study, D. fragilis was identified in 0.9% of patients observed. Its coincidence with enterobiasis, caused by pinworm (Enterobius vermicularis), has been reported. [6] In another study, eosinophilia was present in half of the infected children participating in the case. [5] D. fragilis does not penetrate the host tissue directly; therefore, some of these symptoms may be caused from irritation which then leads to colonic motility. [5] Infection can occur at any age; however, the most common ages that have been reported are children 5–10 years old. [3]

Diagnosis

In order to diagnose the parasite, patients are required to provide (multiple) fresh stool samples that have been preserved for parasite examination. The multiple samples are required because of parasite detection being difficult, therefore, a sample might be obtained each day to help increase the sensitivity. [5] Patients can also be tested for E. vermicularis since the two parasites are known to coincide. [7]

Treatment

Once diagnosed, E. vermicularis is also searched for throughout the body. The age and clinical status of the patient will determine the treatment given. If the patient is a child, a temporary treatment would be offered to test if symptoms can be alleviated, otherwise, another diagnosis and treatment are required. If the child is asymptomatic, then treatment is not necessary. [5] Iodoquinol is the primary drug treatment for dientamoebiasis, unfortunately there are side effects such as abdominal cramping, nausea, and rash. There are other medications that treat dientamoebiasis, including paromomycin and metronidazole. [8] Tetracycline and doxycycline have also been used as a form of treatment. [5] Drugs such as secnidazole and ornidazole have been used as well, but are not available in the United States. [8]

Epidemiology

Dientamoeba fragilis has an estimated prevalence throughout the United States. Unlike majority of parasitic infections, D. fragilis is more prevalent in well-developed countries as opposed to disadvantaged and resource poor nations. [9] The parasite is also endemic in crowded communities (i.e institutions), populations with unsatisfactory sanitation conditions, and individuals who travel to underprivileged countries. [3] Globally, the prevalence of D. fragilis ranges from 0.3% to 90%, occurring in multiple countries including many urbanized cities such as Los Angeles, California and Sydney, Australia. Recently, D. fragilis was considered to be more prevalent than Giardia, thus leading to better diagnostics. [9]

Phylogenetics

Dientamoeba fragilis is a type of trichomonad. Trichomonads are flagellated organisms but D. fragilis lacks flagella, [10] having secondarily lost them over evolutionary time. Thus, it is an amoeba of flagellate ancestry. In point of ultrastructural and antigenic view, Dientamoeba is reclassified as a flagellate.

The lifecycle of this parasite has not yet been completely determined, but some assumptions have been made based on clinical data. A cyst stage has been reported, [11] although it is yet to be independently confirmed (as of 2013). If true, D. fragilis is probably transmitted by the fecal-oral route. Prior to the report of this cyst stage in the lifecycle of Dientamoeba, transmission was postulated to occur by helminth eggs (e.g., Ascaris, Enterobius spp.). The rationale for this suggestion was that D. fragilis is closely related to the turkey parasite Histomonas, which is known to be transmitted by the eggs of the helminth Heterakis. Since D. fragilis is known to frequently coinfect with E. vermicularis, this leads to the assumption that E. vermicularis is a possible vector and mode of transmission. [9]

When inside the host, the parasite infects the mucosal crypts of the large intestine. They primarily affect the cecum and proximal colon. It is assumed that when D. fragilis is inside the colon, it reproduces asexually by binary fission. From there, the trophozoites are in the lumen of the colon, and are excreted as wastes. [12] D. fragilis is not considered to be invasive nor cause cell or tissue damage. [3]

Build

D. fragilis replicates by binary fission, moves by pseudopodia, and feeds by phagocytosis. The cytoplasm typically contains numerous food vacuoles that contain ingested debris, including bacteria. Waste materials are eliminated from the cell through digestive vacuoles by exocytosis. D. fragilis possesses some flagellate characteristics. In the binucleated form is a spindle structure located between the nuclei, which stems from certain polar configurations adjacent to a nucleus; these configurations appear to be homologous to hypermastigotes’ atractophores. A complex Golgi apparatus is seen; the nuclear structure of D. fragilis is more similar to that of flagellated trichomonads than to that of Entamoeba. Also notable is the presence of hydrogenosomes, which are also a characteristic of other trichomonads. [13]

See also

Related Research Articles

<i>Giardia duodenalis</i> Parasitic microorganism that causes giardiasis

Giardia duodenalis, also known as Giardia intestinalis and Giardia lamblia, is a flagellated parasitic protozoan microorganism of the genus Giardia that colonizes the small intestine, causing a diarrheal condition known as giardiasis. The parasite attaches to the intestinal epithelium by an adhesive disc or sucker, and reproduces via binary fission. Giardiasis does not spread to other parts of the gastrointestinal tract, but remains confined to the lumen of the small intestine. The microorganism has an outer membrane that makes it possible to survive even when outside of its host, and which can render it tolerant to certain disinfectants. Giardia trophozoites are anaerobic, and absorb their nutrients from the intestinal lumen. If the organism is stained, its characteristic pattern resembles the familiar "smiley face" symbol.

<i>Entamoeba histolytica</i> Anaerobic parasitic protist

Entamoeba histolytica is an anaerobic parasitic amoebozoan, part of the genus Entamoeba. Predominantly infecting humans and other primates causing amoebiasis, E. histolytica is estimated to infect about 35-50 million people worldwide. E. histolytica infection is estimated to kill more than 55,000 people each year. Previously, it was thought that 10% of the world population was infected, but these figures predate the recognition that at least 90% of these infections were due to a second species, E. dispar. Mammals such as dogs and cats can become infected transiently, but are not thought to contribute significantly to transmission.

<span class="mw-page-title-main">Giardiasis</span> Parasitic disease that results in diarrhea

Giardiasis is a parasitic disease caused by Giardia duodenalis. Infected individuals who experience symptoms may have diarrhoea, abdominal pain, and weight loss. Less common symptoms include vomiting and blood in the stool. Symptoms usually begin one to three weeks after exposure and, without treatment, may last two to six weeks or longer.

<i>Trichomonas vaginalis</i> Species of parasite that causes sexually transmitted infections

Trichomonas vaginalis is an anaerobic, flagellated protozoan parasite and the causative agent of a sexually transmitted disease called trichomoniasis. It is the most common pathogenic protozoan that infects humans in industrialized countries. Infection rates in men and women are similar but women are usually symptomatic, while infections in men are usually asymptomatic. Transmission usually occurs via direct, skin-to-skin contact with an infected individual, most often through vaginal intercourse. The WHO has estimated that 160 million cases of infection are acquired annually worldwide. The estimates for North America alone are between 5 and 8 million new infections each year, with an estimated rate of asymptomatic cases as high as 50%. Usually treatment consists of metronidazole and tinidazole.

<i>Entamoeba coli</i> Species of parasitic amoeba

Entamoeba coli is a non-pathogenic species of Entamoeba that frequently exists as a commensal parasite in the human gastrointestinal tract. E. coli is important in medicine because it can be confused during microscopic examination of stained stool specimens with the pathogenic Entamoeba histolytica. This amoeba does not move much by the use of its pseudopod, and creates a "sur place (non-progressive) movement" inside the large intestine. Usually, the amoeba is immobile, and keeps its round shape. This amoeba, in its trophozoite stage, is only visible in fresh, unfixed stool specimens. Sometimes the Entamoeba coli have parasites as well. One is the fungus Sphaerita spp. This fungus lives in the cytoplasm of the E. coli. While this differentiation is typically done by visual examination of the parasitic cysts via light microscopy, new methods using molecular biology techniques have been developed. The scientific name of the amoeba, E. coli, is often mistaken for the bacterium, Escherichia coli. Unlike the bacterium, the amoeba is mostly harmless, and does not cause as many intestinal problems as some strains of the E. coli bacterium. To make the naming of these organisms less confusing, "alternate contractions" are used to name the species for the purpose making the naming easier; for example, using Esch. coli and Ent. coli for the bacterium and amoeba, instead of using E. coli for both.

<i>Trichomonas</i> Genus of parasitic, flagellated protists

Trichomonas is a genus of anaerobic excavate parasites of vertebrates. It was first discovered by Alfred François Donné in 1836 when he found these parasites in the pus of a patient suffering from vaginitis, an inflammation of the vagina. Donné named the genus from its morphological characteristics. The prefix tricho- originates from the Ancient Greek word θρίξ (thrix) meaning hair, describing Trichomonas’s flagella. The suffix -monas, describes its similarity to unicellular organisms from the genus Monas.

<i>Retortamonas</i> Unicellular organism

Retortamonas is a genus of flagellated excavates. It is one of only two genera belonging to the family Retortamonadidae along with the genus Chilomastix. The genus parasitizes a large range of hosts including humans. Species within this genus are considered harmless commensals which reside in the intestine of their host. The wide host diversity is a useful factor given that species are distinguished based on their host rather than morphology. This is because all species share similar morphology, which would present challenges when trying to make classifications based on structural anatomy. Although Retortamonas currently includes over 25 known species, it is possible that some defined species are synonymous, given that such overlapping species have been discovered in the past. Further efforts into learning about this genus must be done such as cross-transmission testing as well as biochemical and genetic studies. One of the most well-known species within this genus is Retortamonas intestinalis, a human parasite that lives in the large intestine of humans.

<span class="mw-page-title-main">Helminthic therapy</span> Deliberate infestation with parasitic worms

Helminthic therapy, an experimental type of immunotherapy, is the treatment of autoimmune diseases and immune disorders by means of deliberate infestation with a helminth or with the eggs of a helminth. Helminths are parasitic worms such as hookworms, whipworms, and threadworms that have evolved to live within a host organism on which they rely for nutrients. These worms are members of two phyla: nematodes, which are primarily used in human helminthic therapy, and flat worms (trematodes).

<span class="mw-page-title-main">Trichomonadida</span> Order of flagellated protists

Trichomonadida is an order of anaerobic protists, included with the parabasalids. Members of this order are referred to as trichomonads.

Dientamoebiasis is a medical condition caused by infection with Dientamoeba fragilis, a single-cell parasite that infects the lower gastrointestinal tract of humans. It is an important cause of traveler's diarrhea, chronic abdominal pain, chronic fatigue, and failure to thrive in children.

<i>Balamuthia mandrillaris</i> Species of pathogenic Amoebozoa

Balamuthia mandrillaris is a free-living amoeba that causes the rare but deadly neurological condition granulomatous amoebic encephalitis (GAE). B. mandrillaris is a soil-dwelling amoeba and was first discovered in 1986 in the brain of a mandrill that died in the San Diego Wild Animal Park.

<i>Blastocystis</i> Genus of single-celled organisms

Blastocystis is a genus of single-celled parasites belonging to the Stramenopiles that includes algae, diatoms, and water molds. There are several species, living in the gastrointestinal tracts of species as diverse as humans, farm animals, birds, rodents, reptiles, amphibians, fish, and cockroaches. Blastocystis has low host specificity, and many different species of Blastocystis can infect humans, and by current convention, any of these species would be identified as Blastocystis hominis.

The discovery of disease-causing pathogens is an important activity in the field of medical science. Many viruses, bacteria, protozoa, fungi, helminths, and prions are identified as a confirmed or potential pathogen. In the United States, a Centers for Disease Control and Prevention program, begun in 1995, identified over a hundred patients with life-threatening illnesses that were considered to be of an infectious cause but that could not be linked to a known pathogen. The association of pathogens with disease can be a complex and controversial process, in some cases requiring decades or even centuries to achieve.

<span class="mw-page-title-main">Protozoan infection</span> Parasitic disease caused by a protozoan

Protozoan infections are parasitic diseases caused by organisms formerly classified in the kingdom Protozoa. These organisms are now classified in the supergroups Excavata, Amoebozoa, Harosa, and Archaeplastida. They are usually contracted by either an insect vector or by contact with an infected substance or surface.

<span class="mw-page-title-main">Amoebiasis</span> Human disease caused by amoeba protists

Amoebiasis, or amoebic dysentery, is an infection of the intestines caused by a parasitic amoeba Entamoeba histolytica. Amoebiasis can be present with no, mild, or severe symptoms. Symptoms may include lethargy, loss of weight, colonic ulcerations, abdominal pain, diarrhea, or bloody diarrhea. Complications can include inflammation and ulceration of the colon with tissue death or perforation, which may result in peritonitis. Anemia may develop due to prolonged gastric bleeding.

<span class="mw-page-title-main">Pinworm infection</span> Medical condition

Pinworm infection, also known as enterobiasis, is a human parasitic disease caused by the pinworm, Enterobius vermicularis. The most common symptom is itching in the anal area. The period of time from swallowing eggs to the appearance of new eggs around the anus is 4 to 8 weeks. Some people who are infected do not have symptoms.

<i>Trichomonas gallinae</i> Species of bird parasite

Trichomonas gallinae is a cosmopolitan parasite of birds including finches, pigeons, doves, turkeys, chickens, parrots, raptors. The condition in birds of prey is called frounce. It is believed to be an ancient pathogen causing frounce-like symptoms in theropod dinosaurs. The same condition in pigeons is commonly called canker.

<i>Trichomonas tenax</i> Species of single-celled organism

Trichomonas tenax, or oral trichomonas, is a species of Trichomonas commonly found in the oral cavity of humans. Routine hygiene is generally not sufficient to eliminate the parasite, hence its Latin name, meaning "tenacious". The parasite is frequently encountered in periodontal infections, affecting more than 50% of the population in some areas, but it is usually considered insignificant. T. tenax is generally not found on the gums of healthy patients. It is known to play a pathogenic role in necrotizing ulcerative gingivitis and necrotizing ulcerative periodontitis, worsening preexisting periodontal disease. This parasite is also implicated in some chronic lung diseases; in such cases, removal of the parasite is sufficient to allow recovery.

<i>Naegleria fowleri</i> Species of free-living excavate form of protist

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<i>Chilomastix</i>

Chilomastix is a genus of pyriform excavates within the family Retortamonadidae All species within this genus are flagellated, structured with three flagella pointing anteriorly and a fourth contained within the feeding groove. Chilomastix also lacks Golgi apparatus and mitochondria but does possess a single nucleus. The genus parasitizes a wide range of vertebrate hosts, but is known to be typically non-pathogenic, and is therefore classified as harmless. The life cycle of Chilomastix lacks an intermediate host or vector. Chilomastix has a resistant cyst stage responsible for transmission and a trophozoite stage, which is recognized as the feeding stage. Chilomastix mesnili is one of the more studied species in this genus due to the fact it is a human parasite. Therefore, much of the information on this genus is based on what is known about this one species.

References

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