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Amoebiasis

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Amoebiasis is a parasitic infection that occurs in the intestines and is the cause of nearly 100,000 deaths worldwide. It affects approximately 500 million individuals all over the world on a yearly basis. In New York alone, Amoebiasis downs 500 people annually.

Amoebiasis is caused by the protozoan parasite known as Entamoeba histolytica, and it results in an intestinal ailment known as Amoebic dysentery. It is a worldwide illness that affects both first world nations and developing countries. In areas with warmer climates, poor sanitary environments and crowded living spaces, it affects almost 50% of the population. Amoebiasis is also a common affliction in mental institutions, among homosexual males, and tourists who travel overseas to tropical or developing countries.

AMOEBIASIS SIGNS AND SYMPTOMS

Amoebiasis is one of the top three causes of death due to a parasitic infection, the first two being Malaria and Schistosomiasis. The ailment is usually diagnosed in young and middle aged adults who have consumed food or drinking water that have been contaminated with fecal matter where the parasite usually thrives. Amoebiasis can also be transmitted through unhygienic habits, direct or indirect contact with the stool of infected individuals, dirty body parts or personal belongings, as well as through anal-to-oral contact. Contamination can also occur when a person inadvertently touches their mouth with their fingers after having come into contact with surfaces contaminated with E. histolytica eggs or cysts.

The Entamoeba histolytica parasite invades the large intestine in affected people. About 10% of patients who contract Amoebiasis display no symptoms of this type of intestinal infection at all. Asymptomatic Amoebiasis is still a dangerous ailment, however, and it is important that it is diagnosed as soon as possible in order to initiate treatment measures and to ensure that it is eliminated before the infected individual becomes a carrier and inadvertently transmits the parasite to members of the household or community. In typical Amoebiasis cases, which comprise 90% of contaminated individuals, symptoms generally appear within 7 to 30 days after contamination. Very rarely, symptoms may appear before 7 days, or even after 30 days of acquiring the protozoan parasite.

A person with Amoebiasis will experience severe amoebic dysentery, which is indicated by abdominal cramping, diarrhea, stool that is accompanied by blood or mucus, nausea and vomiting, loss of weight, and an intermittent fever. Patients may also experience symptoms that are vague and not specific to the ailment itself.
Amoebiasis
Image: Amoebiasis


When the parasite invades the intestines, these active trophozoites get into the muscles of the intestinal walls and consume the red blood cells within. They continue to eat away at the intestinal epithelium until oblong-shaped ulcers start to form. In very rare cases, approximately 1% of infected individuals, E. histolytica invades the other organs of the body through the bloodstream, thereby causing the formation of amoebic abscesses.

Patients whose livers are affected by these amoebic abscesses frequently exhibit fevers and experience pain on the upper right side of their abdomen, as well as liver tenderness, and jaundice. In extreme cases, jaundice can occur in the lungs and brain, transported through the intestines' venous system.

AMOEBIASIS DIAGNOSIS

There are quite a number of diagnostic methods to determine whether a person has Amoebiasis, as opposed to other parasitic infections such as E. dispar or E. moshkovskii, which are similar to E. histolytica in morphology. Some of the diagnostic methods include antibody detection, antigen detection, PCR technology, isoenzyme electrophoresis, and the use of enzyme immunoassay kits, and enzyme-linked immunosorbent assay to detect the presence of the E. histolytica parasite. For patients who suffer from liver abscesses secondary to Amoebiasis, serology is a recommended method of detection.

The doctor will require a patient to submit a number of stool samples on different days to determine the presence of the E. histolytica parasite. A positive diagnosis will be determined when an infected person's stool contains this type of amoeba with the presence of ingested erythrocytes.

AMOEBIASIS TREATMENT

The first goal of treatment for Amoebiasis is to relieve the symptoms of amoebic dysentery, as well as to prevent further loss in fluids and electrolytes through intake of anti-diarrheal medication. For patients who do not exhibit any symptoms, doctors will usually administer luminal agents such as Diloxanide Furoate or Liodoquinol. To get rid of the parasites infesting the intestines, doctors normally prescribe anti-parasitic treatments like Paromomycin or Metronidazole to destroy any traces of amoebae in intestinal tissue and other surrounding organs.

A five-day round of antibiotics may also be necessary, particularly if a patient exhibits liver abscess or a spread of the parasitic infestation beyond the intestines. For sizeable liver abscesses, an ultrasound scan may be used to accurately pinpoint the location of these abscesses in order to undertake the necessary surgical liver drainage.

Patients suffering from Amoebiasis should refrain from excessive solid food intake during the duration of their illness to avoid intestinal cramping. Alcoholic drinks should also be avoided, as they may cause complications for a person suffering from this ailment.


People can avoid contracting Amoebiasis, particularly if they are at risk, or are traveling to an area considered to be high risk for this type of parasitic infestation. Toilets and bathrooms should be cleaned and disinfected as often as possible. After using the toilet, changing an infant's dirty diaper, or before eating, thorough hand washing with soap and water is recommended. Furthermore, any sexual practices that involve oral and fecal contact should be avoided at all costs.

AMOEBIASIS RISK FACTOR

People in high-risk areas should avoid consuming raw or undercooked food, particularly fruit and vegetables that they are unable to peel, as well as any unpasteurized milk or dairy products. If bottled or filtered water is unavailable, any water intended for drinking should be boiled for at least 20 minutes. People should also avoid drinking from public drinking fountains or consuming any drinks that have ice cubes from a questionable source.

Nails should be regularly cut and kept clean to refrain from becoming repositories of dirt and other fecal matter that may contain E. histolytica eggs. Sharing the personal belongings of infected individuals, such as towels, should be avoided, as well.
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