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A total of 19,252 stool specimens from 12,136 patients were examined by direct microscopy and the ethyl acetate-Formalin concentration method during the last 2 years. All liquid specimens and those in which parasite identification was difficult or equivocal were also examined in trichrome-stained preparations. A total of 3,070 intestinal parasites were seen in 2,889 patients. Blastocystis hominis was found in fecal material from 647 patients (17.5%). A total of 132 cases (25.6%) were observed to be in association with other enteric pathogens. B. hominis in large numbers was present as the only parasite or with other commensals in 515 specimens from patients (79.6%). Of these patients, 239 (46.4%) had symptoms, the most common being abdominal pain (87.9%), constipation (32.2%), diarrhea (23.4%), alternating diarrhea and constipation (14.5%), vomiting (12.5%), and fatigue (10.5%). Forty-three (18%) of the patients were treated with metronidazole (0.5 to 1.0 g/day) because of recurrent symptoms and the presence of large numbers of B. hominis cells in repeated stool specimens. After 7 to 10 days of treatment, all patients became asymptomatic with negative stools on follow-up examinations for B. hominis.
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PMID:Clinical significance of Blastocystis hominis. 235 28

A study of single stool specimens was done to determine the prevalence of intestinal parasites among 1,000 primary school children. A questionnaire was completed by each child's parents. Specimens were examined by using wet-mount preparation, formaline-ether concentration, and Sheather's flotation technique. Trichrome and acid-fast stains were done. Blastocystis hominis was observed in 203 (20.3%) of the specimens examined, and 175 specimens contained this organism in the absence of other pathogenic parasites. Older children had fewer B. hominis infections (6 to 7 years old, 50% infection rate; 8 to 9 years, 27.5%; 10 to 12 years, 9.5%). The most common complaints reported by 75 children harboring the parasite were a mild recurrent diarrhea, abdominal pain, nausea, anorexia, and fatigue. Blastocystosis is quite common among schoolchildren. Contaminated drinking water is suspected to be the source of infection.
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PMID:Intestinal colonization of symptomatic and asymptomatic schoolchildren with Blastocystis hominis. 785 90

Intestinal parasitic infections are major causes of childhood diseases in rural regions. The significant causes of this problem are the insufficient resources to improve the infrastructure in these regions and inadequate health services in both the diagnosis and treatment of diseases. The aim of this study was to assess the association between intestinal parasitic infections and clinical symptoms of infected children. Cellophane tape and stool samples of 100 children, aged between 7-10 years, from two villages of Manisa city, were examined for intestinal parasites and their symptoms were recorded. Although some symptoms, such as abdominal pain, anorexia and fatigue were found to be common in infected children, no significant relationship was found between symptoms and intestinal parasitic infections.
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PMID:Is there an association between clinical symptoms and intestinal parasitic infections? 1636 23

Although knowledge of intestinal parasites predates Hippocrates, the Hippocratic Corpus provides the first scientific observations about the clinical perception and treatment of helminthic diseases. These observations follow the scientific principles of Hippocrates, the father of modern medicine, who relied on knowledge and observation. This article is based on a systematic study of the Hippocratic texts, and presents observations on diseases caused by intestinal parasites with respect to regularity of appearance, patient age, symptoms, and treatment. Three types of helminths are described: "helmins strongyle" (roundworm), "helmins plateia" (flatworm), and "ascaris" (which corresponds to Enterobius vermicularis). Helminthic diseases primarily appear during childhood, well after teething. The described systemic symptoms include weakness, sickness, discomfort, tiredness, anorexia, and emotional instability; gastrointestinal symptoms include change in bowel movements, vomiting, and colic pain in the epigastrium. We identified several accounts of cases of helminthic diseases in the Hippocratic texts. Of particular interest are the descriptions of a helminth emerging from a fistula in the navel region and the surgical treatment of helminthic diseases, reinforced by being described on a dedicatory inscription at the Asclepion in Epidaurus. We finally encountered the use of powerful purgatives as antihelminthics, which have been widely used, even into the 21st century.
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PMID:From the roots of parasitology: Hippocrates' first scientific observations in helminthology. 1791 92

The present study was conducted to determine the prevalence and clinical features of dientamoebiasis in patients presumed to be infected with intestinal parasites. A total of 168 patients were examined for D. fragilis using microscopy (after Wheatley's trichrome staining) and culture (using modified Boeck and Drbohlav's medium). D. fragilis trophozoites were detected in 15 samples (8.9%) examined using trichrome staining and in 50 samples (29.8%) by culture method. Other enteric parasites were common in the study population as 48.8% of patients (82/168) were found harboring intestinal parasites. Blastocystis hominis was the most common, identified in 33.3% (56/168) of the samples. Giardia lamblia was detected in 17.9% (30/168) and E. histolytica/E. dispar in 11.9% (20/168). The symptoms most frequently encountered were diarrhea, abdominal pain and weight loss and fatigue. Diarrhea and abdominal pain were significantly more frequent in patients with dientamoebiasis compared to non pathogenic cases (P < 0.05). Diarrhea was 38.5% of patients infected with D. fragilis compared to 50% of patients infected with G. lamblia, while abdominal pain was encountered with D. fragilis in 41% compared to 33.3% with G. lamblia. These differences were insignificant (P > 0.05).
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PMID:Prevalence and clinical features of Dientamoeba fragilis infections in patients suspected to have intestinal parasitic infection. 1798 91

Microsporidium can cause acute and self-restricted diarrhea cases among immunocompetent patients. The aim of this study was to investigate the presence of intestinal parasites and Microsporidium in patients presenting at the internal diseases polyclinic with some digestive system complaints but no immune suppressive problems, and to detect whether it has anything to do with the complaints. A total of 781 fecal samples were investigated for intestinal parasites and Microsporidium. Intestinal parasites were found in 16.11% and Microsporidium in 6.5%. A significant correlation was observed between the presence of intestinal parasites other than Microsporidium and dyspepsia, while in the case of Microsporidium, a significant frequency of dyspepsia and fatigue was observed. It was found that the presence of Microsporidium does not differ by age and gender. From the findings, it was concluded that patients with digestive system complaints should be examined for Microsporidium in addition to intestinal parasites, and the symptoms of dyspepsia and a lack of appetite should especially be given more careful attention.
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PMID:[The prevalence of Microsporidium among adult patients admitted to the parasitology laboratory at the Inonu University Turgut Ozal Medical Center]. 1864 39

Dientamoebiasis is globally distributed and detected in a large number of subjects with diarrhea, abdominal discomfort, flatulence, fatigue and loss of appetite. The life cycle and transmission of Dientamoeba fragilis are poorly understood. Microscopic examination of permanent stained smears is traditionally employed to diagnose the infection. However, this approach is time-consuming and the success in detecting D. fragilis depends on the microscopist's experience. Hence, only a few laboratories routinely carry out tests for D. fragilis. Consequently, the prevalence of D. fragilis infection is probably underestimated. Although novel, rapid and more sensitive diagnostic tests are becoming available for detecting intestinal parasites, they also possess some limitations. The aim of this study was to emphasize the importance of performing microscopic examination of permanent stained smears from at least one fresh stool specimen after sample arrival at the laboratory, as a mandatory practice for the diagnosis of dientamoebiasis, particulary where it is not possible to perform molecular assays.
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PMID:The importance of considering the neglected intestinal protozoan parasite Dientamoeba fragilis. 3105 Jun 25