Dientamoeba fragilis: An emerging intestinal parasite to cause colitis

Diarrhea is one of the major health problems in Indonesia, particularly in children, because of its impact on child development. Many cases of chronic bloody diarrhea in children caused by metronidazole-resistant ameba have been reported in the past 2 years. Therefore, conducting a specific parasitological examination of fecal samples in cases of diarrhea is essential. We conducted a fecal analysis of ten samples from cases of diagnosed as colitis and suspected amebic dysentery. The results revealed Dientamoeba fragilis as the causative agent of the mucus diarrhea. Five of our patients had a single infection of D. fragilis, and the remainder had co-infections of D. fragilis with Blastocystis spp.or with Entamoeba histolytica/dispar. This is the first report of D. fragilis as the causative agent of colitis and diarrhea in Indonesia. Our results suggested that a fresh fecal specimen is crucial to establish the diagnosis of D. fragilis infection.