Is the treatment of Enterobius vermicularis co-infection necessary to eradicate Dientamoeba fragilis infection?

• Main Authors: José A. Boga, Susana Rojo, Jonathan Fernández, Mercedes Rodríguez, Carmen Iglesias, Pablo Martínez-Camblor, Fernando Vázquez, Azucena Rodríguez-Guardado
• Format: Article
• Language: English
• Published: Elsevier 2016-08-01
• Series: International Journal of Infectious Diseases
• Subjects: Dientamoeba fragilis; Treatment; Metronidazole; Enterobius vermicularis; Parasite infection
• Online Access: http://www.sciencedirect.com/science/article/pii/S1201971216310700
• ISSN: 1201-9712; 1878-3511

Objectives: Dientamoeba fragilis is a pathogenic protozoan of the human gastrointestinal tract with a worldwide distribution, which has emerged as an important and misdiagnosed cause of chronic gastrointestinal illnesses such as diarrhea and ‘irritable-bowel-like’ gastrointestinal disease. Very little research has been conducted on the use of suitable antimicrobial compounds. Furthermore, higher rates of co-infection with Enterobius vermicularis have been described, suggesting that E. vermicularis could influence the treatment of D. fragilis-infected patients. To study this, the treatment of E. vermicularis and D. fragilis co-infected patients was evaluated. Methods: Forty-nine patients with a D. fragilis infection, including 25 (51.0%) patients co-infected with E. vermicularis, were studied. All of them were treated with metronidazole. Patients with E. vermicularis co-infection and/or an E. vermicularis-positive case in the family were treated with mebendazole. Results: Metronidazole treatment failure was significantly more frequent in patients with E. vermicularis co-infection and in patients with children in the family. Conclusions: Co-infection with E. vermicularis may act as a factor favoring D. fragilis infection by preventing eradication measures. This suggests that both parasites should be treated simultaneously.