Amoebiasis

Amoebiasis, (amebiasis or entamoebiasis, Aмебиаз, مرض الاميبيا), is a bacterial infectious disease caused by ingesting food contaminated with any of the amoebas of the Entamoeba group and characterized by symptoms common in Entamoeba histolytica infection.

Amebiasis can present with no, mild, or severe symptoms.

Classification

Forms
A. Intestinal amebiasis:	B. Extraintestinal amebiasis:	C. Cutaneous amoebiasis (rare form)
1. Amebic colitis 2. Amebic appendicitis 3. Amoeboma	1. Amoebic hepatitis 2. Amoebic liver abscesses, lung, spleen, brain

 

Pathogen – Entamoeba histolytica

Epidemiology

1- Source of infection – a patient or carrier.

2- Mechanism of transmission – fecal-oral; by means of – water, food, or contact.

Clinical picture

1- Incubation period from 1 – 2 weeks to a few months.

2- Intoxication Syndrome, Moderate weakness, malaise, low-grade or normal temperature

3- Gastrointestinal syndrome, Stool frequent, up to 20 times a day, in the form of a glassy mucus mixed with blood (“raspberry jelly”), scant.

Severe dehydration at this stage does not occur.

Abdominal pain, spastic in nature, in the course of the large intestine projection, thickened cecum on palpation; the sigmoid is spasmodic, stomach moderately swollen, painful on palpation in the iliac region, tenesmus in the presence of amoebic proctitis.

4- The amebic liver abscess is characterized by chills, prolonged fever, pronounced symptoms of intoxication, enlargement of the liver and its tenderness at the site of the abscess, muscle tension in the right upper quadrant, sometimes the development of jaundice (hepatitis).

5- Amebic lung abscess arises in hematogenous drift of amoebas or from a torn liver abscess in the lung, often takes a chronic course.

6- Skin amebiasis, usually secondary, characterized by the appearance of erosions, ulcers, usually on the skin of the perineum and buttocks.

Complications of intestinal amebiasis: amebic pericolitis, appendicitis, perforation of the intestinal wall with peritonitis, intestinal bleeding, intestinal strictures.

Differential diagnosis

Intestinal amebiasis dif diagnosis is performed with dysentery, ulcerative colitis, intestinal oncopathology, balantidiasis.

Laboratory diagnosis

Detection of amoebae by microscopy of native preparations excreta within 20 minutes following the act of defecation in intestinal amebiasis. ultrasound, X-rays during extra-intestinal amebiasis and Microscopy of native preparations discharged from ulcers in cutaneous amebiasis, TPHA, ELISA – in all forms of amebiasis.

Endoscopy:

A clinical picture of ulcerative colitis, mainly affecting cecum and ascending colon (ulcerative process on the background of intact mucosa), presence of polyps, cysts amoebas.

Treatment

Etiotropic therapy: metronidazole 2.5 g / day for a period of 5-8 days.

Tinidazole 2 g / day for a period of 3 days.

Digidroemetin to 0.09 / day for a period of 5 days in case of intestinal amebiasis and 10 days in case of extraintestinal.

Amoebic abscesses of the liver, lungs, brain and other organs are treated surgically in combination with antiamoebic agents (metronidazole, hingamin, emetine).

 

Verified by: Dr.Diab (January 7, 2017)

Citation: Dr.Diab. (January 7, 2017). Amoebiasis. Medcoi Journal of Medicine, 8(2). urn:medcoi:article15934.