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ENDOLIMAX NANA

Although much literature cites this parasite as a non-pathogen, there is much reason to believe that in some cases these "non-pathogenic" agents actually cause symptoms in patients, with no other infections or conditions that would explain their symptoms. Following is a list of a few references to support that statement:

Cuffari C, Oligny L, Siedman EG, 1998 Dientamoeba fragilis masquerading as allergic colitis. J. Pediatr Gastroenterol Nutr 26: 16-20.

Feigin, RD, Cherry, James, Demmler-Harrison, GJ, and Kaplan, SL. Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 6th Edition; Ch. 223

Amin, OM, 2002. Seasonal Prevalence of Intestinal Parasites in the United States During 2000. Am J. Trop. Med. Hyg., 66(6), 799-803.

Garcia LS, 2005. Diagnostic Medical Parasitology. Washington, DC: American Society for Microbiology. Pg. 9 and Corcoran G.D., O'Connell B., Gilleece A., Mulvihill T.E.: Entamoeba coli as possible cause of diarrhea. Lancet 1991; 338:254

BIOLOGY

CAUSAL AGENTSEntamoeba coli, E. hartmanni, E. polecki, Endolimax nana, and Iodamoeba buetschlii are generally considered nonpathogenic and reside in the large intestine of the human host. Entamoeba gingivalis is also considered nonpathogenic and resides in the oral cavity of the human host, in the gingival pockets at the base of the teeth.LIFE CYCLE

Life cycle of nonpathogenic intestinal amebae

Entamoeba coli, E. hartmanni, E. polecki, Endolimax nana, and Iodamoeba buetschlii are generally considered nonpathogenic and reside in the large intestine of the human host . Both cysts and trophozoites of these species are passed in stool and considered diagnostic . Cysts are typically found in formed stool, whereas trophozoites are typically found in diarrheal stool. Colonization of the nonpathogenic amebae occurs after ingestion of mature cysts in fecally-contaminated food, water, or fomites . Excystation occurs in the small intestine and trophozoites are released, which migrate to the large intestine. The trophozoites multiply by binary fission and produce cysts, and both stages are passed in the feces . Because of the protection conferred by their cell walls, the cysts can survive days to weeks in the external environment and are responsible for transmission. Trophozoites passed in the stool are rapidly destroyed once outside the body, and if ingested would not survive exposure to the gastric environment.

LIFE CYCLE (Entamoeba gingivalis):

Life cycle of Entamoeba gingivalis

There is no known cyst stage for Entamoeba gingivalis; trophozoites live in the oral cavity of humans, residing in the gingival pockets near the base of the teeth . They are not considered pathogenic, and feed on bacteria and other debris. Trophozoites are transmitted person-to-person orally by kissing or fomites (such as eating utensils) . The trophozoite stage of E. gingivalis is morphologically similar to that of E. histolytica, and the two should be differentiated, as both can be coughed up in sputum specimens (for the latter, when present in pulmonary abscesses).

GEOGRAPHIC DISTRIBUTION

All six species are distributed worldwide. Entamoeba polecki in nature is primarily a parasite of pigs and monkeys, and human infection is more prevalent in areas where the people have animal contact.

CLINICAL FEATURES

Entamoeba coli, E. hartmanni, E. polecki, Endolimax nana, and Iodamoeba buetschlii are generally considered nonpathogenic, although they have been found in the stool of patients presenting with diarrhea where no known pathogens were identified. Their presence in stool can be an indicator of fecal contamination of a food or water source, and does not rule-out the presence of other parasites. Entamoeba gingivalis is also considered nonpathogenic, but is found in about 95% of patients with gum disease and about 50% of patients with healthy gums.

LABORATORY DIAGNOSIS

For E. coli, E. hartmanni, E. polecki, E. nana, and I. buetschlii, identification is made by observing cysts and/or trophozoites in stool specimens, both concentrated wet mounts and permanent stained smears. Identification of E. gingivalis is made by the finding of trophozoites in scrapings of the gums and teeth. They may also be found in sputum in rare occasions. As such, it is important to differentiate them from the morphologically-similar trophozoites of E. histolytica, which may be found in sputum from pulmonary abscesses.

 

For more information view the source:Center for Disease Control

Recommended Test:Full GI Panel

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