P1: RLJ/OZN P2: KUF
0521779407-D-01 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:41
Diarrhea Dientamoeba Fragilis Infection 485■Antimotility agents: may cause toxic megacolon, sequelae of disease
process may occur in the presence of infection
➣Contraindication: some infectious etiologies
■Octreotide: delays gallbladder emptying predisposing to gallstones,
hyperglycemia
■Anti-inflammatory agents/Immunosuppressive agents: Cushing’s
syndrome, immunosuppression, infectious complications, bone
marrow suppression, kidney and liver disease, hyperglycemia, psych
disorders, electrolyte disorders, HPA axis suppression, osteoporosis
■Clonidine: rebound hypertension if stopped abruptly, postural
hypotension, depression, anticholinergic side effects, impotence,
arrhythmias, sedation, myalgias
➣Contraindication: severe CAD, pregnancy
■Cholestyramine: steatorrhea with high doses, constipation, osteo-
porosis, rash, vitamin deficiencies, fecal impaction
➣Contraindication: complete biliary obstruction
follow-up
■Ensure maintenance of nutritional status, blood counts, hydration
complications and prognosis
■Dehydration/electrolyte imbalances
■Malnutrition/malabsorption
■Anemia
■Weight loss
■Renal failure/specific complications of certain infections
■Shock/deathDientamoeba Fragilis Infection..........................
J. GORDON FRIERSON, MD
history & physical
History
■Exposure: It is presumed that a cyst form of Dientamoeba fragilis is
ingested in contaminated food and/or water (cyst form has never
been seen).
Signs & Symptoms
■Many patients have no symptoms. Some have low-grade diarrhea,
flatulence, abdominal discomfort. Abdominal examination normal,
or slight tenderness in lower abdomen.