Gastroenterologist's answer:Dientamoeba fragilis is a protozoan parasite that infests the cecum and ascending colon of about 2-4% of the population. The problem for the clinician is the fact that colonization with Dientamoeba doesn't necessarily mean the person is ill. Still, children who excrete this protozoan in their stool are more likely to have abdominal symptoms such as diarrhea, abdominal pain, nausea and flatulence than children who aren't hosts to this parasite. About half of children with Dientamoeba fragilis colonization will display eosinophilia characteristics of a parasitic infection. They may also have pinworms, possibly the mode of transmission for the Dientamoeba parasite. I wouldn't treat an asymptomatic patient with a positive stool, but if there are symptoms, children may respond to metronidazole, iodoquinol, or even erythromycin. NS

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