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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
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| {{Infobox_Disease |
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| Name = {{PAGENAME}} |
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| Image = |
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| Caption = |
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| DiseasesDB = |
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| ICD10 = {{ICD10|A|06||a|00}} |
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| ICD9 = {{ICD9|006}} |
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| ICDO = |
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| OMIM = |
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| MedlinePlus = |
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| eMedicineSubj = |
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| eMedicineTopic = |
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| MeshID = D000562 |
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| }}
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| {{Amoebiasis}} | | {{Amoebiasis}} |
| {{CMG}} | | {{About1|Entamoeba histolytica}} |
| ==Overview== | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''<br> |
| | {{CMG}}; {{AE}} {{JH}}, {{Tamar}}<br> |
| | {{SK}} Entamoebiasis; Amebiasis |
| | ==[[Amoebiasis overview|Overview]]== |
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| ==Nature of the disease== | | ==[[Amoebiasis historical perspective|Historical Perspective]]== |
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| ==Relative frequency of the disease == | | ==[[Amoebiasis classification|Classification]]== |
| In older textbooks it is often stated that 10% of the world's population is infected with ''[[Entamoeba histolytica]]''. It is now known that at least 90% of these infections are due to E. dispar. Nevertheless, this means that there are up to 50 million true ''E. histolytica'' infections and approximately seventy thousand die each year, mostly from liver abscesses or other complications. Although usually considered a tropical parasite, the first case reported (in 1875) was actually in St Petersburg in Russia, near the Arctic Circle. Infection is more common in warmer areas, but this is both because of poorer hygiene and because the parasite cysts survive longer in warm moist conditions.
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| ==Treatment== | | ==[[Amoebiasis pathophysiology|Pathophysiology]]== |
| ''E. histolytica'' infections occur in both the intestine and (in people with symptoms) in tissue of the intestine and/or liver. As a result two different sorts of drugs are needed to rid the body of the infection, one for each location. [[Metronidazole]], or a related drug such a [[tinidazole]], is used to destroy amebae that have invaded tissue. It is rapidly absorbed into the bloodstream and transported to the site of infection. Because it is rapidly absorbed there is almost none remaining in the intestine. Since most of the amebae remain in the intestine when tissue invasion occurs, it is important to get rid of those also or the patient will be at risk of developing another case of invasive disease. Several drugs are available for treating intestinal infections, the most effective of which has been shown to be [[Paromomycin]] (also known as Humatin); diloxanide furoate is used in the US. Both types of drug must be used to treat infections, with metronidazole usually being given first, followed by paromomycin or diloxanide. ''E. dispar'' does not require treatment, but many laboratories (even in the developed world) do not have the facilities to distinguish this from ''E. histolytica''.
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| For amebic dysentery a multi-prong approach must be used, starting with one of:
| | ==[[Amoebiasis causes|Causes]]== |
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| *[[Metronidazole]] 500-750mg three times a day for 5-10 days
| | ==[[Amoebiasis differential diagnosis|Differentiating Amoebiasis from other Diseases]]== |
| *[[Tinidazole]] 2g once a day for 3 days is an alternative to metronidazole
| | ==[[Amoebiasis epidemiology and demographics|Epidemiology and Demographics]]== |
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| In addition to the above, one of the following luminal amebicides should be prescribed as an adjunctive treatment, either concurrently or sequentially, to destroy ''[[E. histolytica]]'' in the colon:
| | ==[[Amoebiasis risk factors|Risk Factors]]== |
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| *[[Paromomycin]] 500mg three times a day for 10 days
| | ==[[Amoebiasis natural history|Natural History, Complications and Prognosis]]== |
| *[[Diloxanide furoate]] 500mg three times a day for 10 days
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| *[[Iodoquinol]] 650mg three times a day for 20 days
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| For amebic liver abscess:
| | ==Diagnosis== |
| *[[Metronidazole]] 400mg three times a day for 10 days
| | [[Amoebiasis history and symptoms|History and Symptoms]] | [[Amoebiasis physical examination|Physical Examination]] | [[Amoebiasis laboratory tests|Laboratory Findings]] | [[Amoebiasis imaging|Imaging]] |
| *[[Tinidazole]] 2g once a day for 6 days is an alternative to metronidazole
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| *[[Diloxanide furoate]] 500mg three times a day for 10 days must always be given afterwards
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| Doses for children are calculated by body weight and a pharmacist should be consulted for help.
| | ==Treatment== |
| | | [[Amoebiasis medical therapy|Medical Therapy]] | [[Amoebiasis surgery|Surgery]] | [[Amoebiasis prevention|Prevention]] | [[Amoebiasis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Amoebiasis future or investigational therapies|Future or Investigational Therapies]] |
| ==Herbal treatments== | |
| In Mexico, it is common to use herbal tinctures of ''chaparro amargo'' (English: castela). 30 drops are taken in a small glass of water first thing in the morning, and 30 drops before the last meal of the day, for seven days straight. After taking a seven day break from the treatment, it is resumed for seven days. Some mild cramping may be felt; it is claimed this means that the amoebas are dying and will be expelled from the body. Many Mexicans use the chaparro amargo treatment regularly, three times a year. The efficacy of such treatments has not been scientifically proven.
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| A 1998 study in Africa suggests that 2 tablespoons per week of [[papaya]] seeds may have some antiamoebic action and aid in prevention of amoebiasis, but this remains unconfirmed. Papaya fruit and seeds are often considered beneficial to digestion in areas where this plant is common.
| | ==Case Studies== |
| | | [[Amoebiasis case study one|Case #1]] |
| ==Complications== | |
| In the majority of cases, amoebas remain in the gastrointestinal tract of the hosts. Severe ulceration of the gastrointestinal mucosal surfaces occurs in less than 16% of cases. In fewer cases, the parasite invades the soft tissues, most commonly the liver. Only rarely are masses formed (amoebomas) that lead to intestinal obstruction.
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| ''Entamoeba histolytica'' infection is associated with malnutrition and stunting of growth.<ref>{{cite journal | author=Mondal D, Petri Jr WA, Sack RB, ''et al.'' | title=''Entamoeba histolytica''-associated diarreal illness is negatively associated with the growth of preschool shildren: evidence from a prospective study | journal=Trans R Soc Trop Med H | year=2006 | volume=100 | issue=11 | pages=1032–38 | doi=10.1016/j.trstmh.2005.12.012 }}</ref>
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| ==Populations at risk==
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| All people are believed to be susceptible to infection and there is no evidence that individuals with a damaged or undeveloped immunity may suffer more severe forms of the disease.
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| ==Food analysis==
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| ''E. histolytica'' cysts may be recovered from contaminated food by methods similar to those used for recovering ''[[Giardia lamblia]]'' cysts from feces. Filtration is probably the most practical method for recovery from drinking water and liquid foods. ''E. histolytica'' cysts must be distinguished from cysts of other parasitic (but nonpathogenic) protozoa and from cysts of free-living protozoa as discussed above. Recovery procedures are not very accurate; cysts are easily lost or damaged beyond recognition, which leads to many falsely negative results in recovery tests. (See the FDA Bacteriological Analytical Manual.)
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| ==Outbreaks==
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| The most dramatic incident the USA was the Chicago World's Fair outbreak in 1933 caused by contaminated drinking water; defective plumbing permitted sewage to contaminate water. There were 1,000 cases (with 58 deaths). In recent times, food handlers are suspected of causing many scattered infections, but there has been no single outbreak.
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| == Colon: Amebiasis==
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| <youtube v=Xti6OURHxhc/>
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| ==References==
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| {{reflist|2}}
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| {{Protozoal diseases}} | | {{Protozoal diseases}} |
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| {{SIB}}
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| [[de:Amöbenruhr]]
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| [[fr:Amabiase]]
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| [[nl:Amoebiasis]]
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| [[ja:アメーバ赤痢]]
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| [[Category:Mature chapter]]
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| [[Category:Parasitic diseases]] | | [[Category:Parasitic diseases]] |
| [[Category:Water-borne diseases]] | | [[Category:Water-borne diseases]] |
| [[Category:Infectious disease]]
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| [[Category:Mature chapter]] | | [[Category:Mature chapter]] |
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| [[pl:Czerwonka amebowa]]
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