Multiple sampling and SAF-fixative triple-faeces testing for dysbiosis and pathogenic infections of the gastrointestinal tract: Case report

The classic presentation of acute gastrointestinal (GI) parasitic infection including fever, diarrhea, nausea, and/or abdominal pain is not always a reliable measure. In these cases, parasitic infections require sensitive stool testing to be identified and treated effectively. The standard practice for stool analysis typically requires 3 separate stool specimens to be collected on 3 separate days to overcome the possibility of misdiagnosis due to intermittent shedding. Nonetheless, this practice is not often utilized due to very short periods of sample viability, which often leads to patient misdiagnosis. In this study, a patient with a history that eluded to possible acute GI parasitic infection, but without classic symptomology, was screened using a sodium acetate acetic acid formalin (SAF)-fixative triple-faeces test. Even though the patient’s symptoms did not strongly suggest stool analysis, her history of travel was clinically relevant. The faeces test revealed the patient was positive for Blastocystis hominis, Dientamoeba fragilis trophs, Endolimax nana trophs, Entamoeba coli trophs, a-hemolytic Streptococcus, Enterobacter cloacae, Klebsiella pneumoniae, and yeast. Subsequently, the patient was treated for GI infection and received significant symptom relief. This case supports the concept that physicians should fully evaluate a patient’s clinical presentation and symptomology, including history and environmental exposures, and include highly sensitive testing for proper evaluation of potential GI parasitic infections.