Jay had missed several days of school but the blood tests ordered by his doctor had come back normal, except for the fact his iron was low, nothing seemed to be wrong.

“He was a very, very sick boy,” said Victoria-based Ellen, “I thought at first maybe he had bad constipation and that he wasn’t eating properly, but one day I saw him getting out of the shower and he was skeletal.”

Ellen was shocked and decided enough was enough, she took Jay to the doctor and asked for help.

Because of Jay’s symptoms, the doctor ordered a helicobacter breath test and a faecal test.

As a phlebotomist herself, Ellen is familiar with the world of pathology but also knows how important it is for doctors to know which tests to request.

“The doctor was great, she ordered additional tests including a multiplex faecal pathogen detection test. We were lucky that she was so thorough as the parasite may not have shown up in the micro and culture tests most doctors would order.”

The pathology report came back with two positive results, the faecal test had detected the parasite Dientamoeba fragilis and the breath test was positive for Helicobacter pylori.

“It was a double whammy,” said Ellen, “but a relief to finally know what was going on. I was beginning to get worried that the symptoms were down to anxiety. Jay was losing all this unexplained weight and the fatigue was totally changing his persona.”

Both D. fragilis and H. pylori infections are quite common and can occur without symptoms so many cases go undetected.

In Jay’s case, the doctor suspected he had picked up the parasite from river water when camping several months before, however this parasite and its disease-causing potential is a controversial topic in medical circles. There is a lack of conclusive evidence about whether the parasite causes symptoms like Jay’s, but it can indicate exposure to contaminated food and/or water; so can be an indicator organism, rather than a true pathogen. Therefore, specific testing for D. fragilis is not usually recommended.

It is likely Jay’s symptoms were mainly caused by the H. pylori infection. H. pylori can cause ulcers in the stomach and small intestine and has also been linked to gastric cancers.

Jay was prescribed antibiotics and iron therapy.

“Three weeks later he was back to his old self,” said Ellen.

General hygiene measures such as handwashing, good sanitation and food hygiene are the best preventative actions to protect against parasitic and bacterial infections like these.

The post How pathology solved the puzzle of 12-year-old Jay’s pain first appeared on Know Pathology Know Healthcare.