AMOEBIASIS IN ENGLISH

                                                   

                                            AMOEBIASIS IN ENGLISH

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AMOEBIASIS

Ø  Amebiasis is a parasitic infection of the intestines caused by the protozoan Entamoeba histolytica. It is also known as amebic dysentery.

Ø  E histolytica exists in 2 forms: the hardy infective cyst and the more fragile potentially pathogenic trophozoite. The parasite may act as a commensal or invade the tissues and give rise to intestinal or extraintestinal disease.

HOW IT SPREADS-

Ø  Amebiaisis spreads through feco-oral route. It transmits Mainly through ingestion of contaminated food or water containing amoebic cysts, which are relatively chlorine resistant.

CLINICAL MANIFESTATIONS-

Ø  Main signs and symptoms  of amebiasis are- 

Ø   Intestinal disease varies from acute or fulminating dysentery with fever, chills and bloody or mucoid diarrhea (amoebic dysentery), to mild abdominal discomfort with diarrhea containing blood or mucus, alternating with periods of constipation

Ø  Amoebic granulomata (amoeboma),  may occur in the wall of the large intestine in patients with intermittent dysentery or colitis of long duration.

Ø  Ulceration of the skin, usually in the perianal region, occurs rarely by direct extension from intestinal lesions

Ø  The parasite may be carried by the bloodstream from the intestines to the liver causing liver abscess. Liver abscess commonly present as right upper quadrant abdominal pain and fever, Profuse sweating and rigors Loss of weight , with worsening features associated with abscess rupture.

DIAGNOSITIC INVESTIGATIONS-

Ø  Diagnosis is by microscopic demonstration of trophozoites or cysts in fresh or suitably preserved fecal specimens, smears of aspirates or scrapings obtained by proctoscopy or aspirates of abscesses or sections of tissue.

TREATMENT-

Ø  Use of antibiotics-

Ø  E histolytica is sensitive to someantibiotics such as metronidazole, tinidazole and diloxanide furoate.

Ø  Treatment of dehydration-

Ø  Patient may have dehydration due to dysentery so ORS is also advised.

Ø  Surgical management-

Ø  Surgery may be needed in severe ulcerative colitis and perforation in which the affected part may be removed.

Ø  Surgery may also be needed in severe liver abscess to drain the abscess followed by antibiotics and anti-inflammatory drugs.

 

PREVENTION-

Ø  Good practices in food preparation (food hygiene) is a very good method of prevention.

Ø  Good practices in water filtration, disinfection  and storage of drinking water. 

Ø  Educate the general public in personal hygiene, particularly in sanitary disposal of feces and in hand washing after defecation and before preparing or eating food.

Ø  Provide health education regarding the risks involved in eating un-cleaned or uncooked fruits and vegetables and in drinking contaminated water.

Ø  Public water supplies should be protected from fecal contamination and disposal of human feces should be in a sanitary manner.

Ø  Isolation: For hospitalized patients, enteric precautions in the handling of feces, contaminated clothing and bed linen.

Ø  Exclusion of individuals infected with E. histolytica from food handling and from direct care of hospitalized and institutionalized patients.