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A Mexican Honeymoon Marred by Gastrointestinal Upset: A Case of Dientamoeba fragilis Causing Post-infectious Irritable Bowel Syndrome

Dientamoeba fragilis (D. fragilis) is an anaerobic intestinal protozoan parasite that has been associated with irritable bowel syndrome (IBS)-like symptoms. We report a case of post-infectious IBS caused by D. fragilis treated successfully with metronidazole. A 33-year-old African American male with...

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Autores principales: Ali, Saeed, Khetpal, Neelam, Khan, Muhammad Talha, Rasheed, Mamoon, Asad-Ur-Rahman, FNU, Echeverria-Beltran, Karen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5828670/
https://www.ncbi.nlm.nih.gov/pubmed/29503786
http://dx.doi.org/10.7759/cureus.1992
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author Ali, Saeed
Khetpal, Neelam
Khan, Muhammad Talha
Rasheed, Mamoon
Asad-Ur-Rahman, FNU
Echeverria-Beltran, Karen
author_facet Ali, Saeed
Khetpal, Neelam
Khan, Muhammad Talha
Rasheed, Mamoon
Asad-Ur-Rahman, FNU
Echeverria-Beltran, Karen
author_sort Ali, Saeed
collection PubMed
description Dientamoeba fragilis (D. fragilis) is an anaerobic intestinal protozoan parasite that has been associated with irritable bowel syndrome (IBS)-like symptoms. We report a case of post-infectious IBS caused by D. fragilis treated successfully with metronidazole. A 33-year-old African American male with an unremarkable past medical history was seen in the office with a three-month history of intermittent, generalized, crampy abdominal pain with bloating and flatulence without associated weight loss. He visited Mexico for his honeymoon four months ago. Initial lab work was normal. Dietary changes including fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet and loperamide were prescribed with the presumptive diagnosis of IBS; however, his symptoms persisted. Three samples of stool for ova and parasites (O&P) were positive for D. fragilis. The patient was treated with metronidazole for 14 days. Repeat fecal O&P were negative. Upon follow-up, the patient’ symptoms substantially improved with a resolution of abdominal pain and flatulence. Infection caused by D. fragilis may be symptomatic or asymptomatic. It is transmitted by the fecal-oral route. Symptoms include abdominal pain, bloating, and alteration of bowel movements, resembling IBS. The diagnosis is made via the detection of D. fragilis trophozoites in appropriately fixed and stained stool samples or by a polymerase chain reaction. Treatment options include tetracyclines, paromomycin, metronidazole, and Iodoquinol. Further epidemiologic studies may help in elucidating the association between D. fragilis and IBS.
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spelling pubmed-58286702018-03-02 A Mexican Honeymoon Marred by Gastrointestinal Upset: A Case of Dientamoeba fragilis Causing Post-infectious Irritable Bowel Syndrome Ali, Saeed Khetpal, Neelam Khan, Muhammad Talha Rasheed, Mamoon Asad-Ur-Rahman, FNU Echeverria-Beltran, Karen Cureus Internal Medicine Dientamoeba fragilis (D. fragilis) is an anaerobic intestinal protozoan parasite that has been associated with irritable bowel syndrome (IBS)-like symptoms. We report a case of post-infectious IBS caused by D. fragilis treated successfully with metronidazole. A 33-year-old African American male with an unremarkable past medical history was seen in the office with a three-month history of intermittent, generalized, crampy abdominal pain with bloating and flatulence without associated weight loss. He visited Mexico for his honeymoon four months ago. Initial lab work was normal. Dietary changes including fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet and loperamide were prescribed with the presumptive diagnosis of IBS; however, his symptoms persisted. Three samples of stool for ova and parasites (O&P) were positive for D. fragilis. The patient was treated with metronidazole for 14 days. Repeat fecal O&P were negative. Upon follow-up, the patient’ symptoms substantially improved with a resolution of abdominal pain and flatulence. Infection caused by D. fragilis may be symptomatic or asymptomatic. It is transmitted by the fecal-oral route. Symptoms include abdominal pain, bloating, and alteration of bowel movements, resembling IBS. The diagnosis is made via the detection of D. fragilis trophozoites in appropriately fixed and stained stool samples or by a polymerase chain reaction. Treatment options include tetracyclines, paromomycin, metronidazole, and Iodoquinol. Further epidemiologic studies may help in elucidating the association between D. fragilis and IBS. Cureus 2017-12-27 /pmc/articles/PMC5828670/ /pubmed/29503786 http://dx.doi.org/10.7759/cureus.1992 Text en Copyright © 2017, Ali et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Ali, Saeed
Khetpal, Neelam
Khan, Muhammad Talha
Rasheed, Mamoon
Asad-Ur-Rahman, FNU
Echeverria-Beltran, Karen
A Mexican Honeymoon Marred by Gastrointestinal Upset: A Case of Dientamoeba fragilis Causing Post-infectious Irritable Bowel Syndrome
title A Mexican Honeymoon Marred by Gastrointestinal Upset: A Case of Dientamoeba fragilis Causing Post-infectious Irritable Bowel Syndrome
title_full A Mexican Honeymoon Marred by Gastrointestinal Upset: A Case of Dientamoeba fragilis Causing Post-infectious Irritable Bowel Syndrome
title_fullStr A Mexican Honeymoon Marred by Gastrointestinal Upset: A Case of Dientamoeba fragilis Causing Post-infectious Irritable Bowel Syndrome
title_full_unstemmed A Mexican Honeymoon Marred by Gastrointestinal Upset: A Case of Dientamoeba fragilis Causing Post-infectious Irritable Bowel Syndrome
title_short A Mexican Honeymoon Marred by Gastrointestinal Upset: A Case of Dientamoeba fragilis Causing Post-infectious Irritable Bowel Syndrome
title_sort mexican honeymoon marred by gastrointestinal upset: a case of dientamoeba fragilis causing post-infectious irritable bowel syndrome
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5828670/
https://www.ncbi.nlm.nih.gov/pubmed/29503786
http://dx.doi.org/10.7759/cureus.1992
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