Entamoeba histolytica: Difference between revisions
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Entamoeba histolytica
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* Microscopically distinguishable from the non-pathogenic ''E. dispar'', so needs molecular tests to confirm diagnosis |
* Microscopically distinguishable from the non-pathogenic ''E. dispar'', so needs molecular tests to confirm diagnosis |
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== Management == |
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=== Liver abscess === |
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* Either |
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** [[Is treated with::Metronidazole]] 750 mg PO tid for 10 days |
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** [[Is treated with::Tinidazole]] 2 g PO daily for 5 days |
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* Followed by a luminal agent, either |
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** [[Is treated by::Paramomycin]] 10 mg/kg PO tid for 5 to 10 days |
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** [[Is treated by::Diloxanide furoate]] 500 mg PO tid for 10 days |
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=== Diarrhea === |
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* [[Is treated by::Tinidazole]] 2 g PO daily for 5 days |
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* Followed by a luminal agent, as above |
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=== Asymptomatic carriage === |
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* Treat with a luminal agent, as above |
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{{DISPLAYTITLE:''Entamoeba histolytica''}} |
{{DISPLAYTITLE:''Entamoeba histolytica''}} |
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[[Category:Protozoa]] |
[[Category:Protozoa]] |
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Revision as of 18:37, 9 December 2019
Background
Microbiology
- Intestinal protozoan parasite within the genus Entamoeba
- Microscopically distinguishable from the non-pathogenic E. dispar, E. moshkovskii, and E. bangladeshii
Epidemiology
- Causes 34 to 50 million cases annually and up to 100,000 deaths
Clinical Presentation
Amoebic diarrhea and dysentery
- Amoebic diarrhea, with or without dysentery, is common
- About 15 to 30% of cases involve amoebic dysentery (with macroscopic or microscopic blood)
- Typically a subacute onset over 3 to 4 weeks and abdominal pain
- However, can be up to months
- Fever is rare, even in dysentery
- In children, can lead to intussusception, perforation, and necrotizing colitis
Amoebic liver abscess
- Amoebic liver abscess is far more common in men than women, and rare in children
- Symptoms progress over 2 to 4 weeks, with fever, cough, and abdominal pain
- The pain is typically a dull ache in the right upper quadrant or epigastrium
Disseminated emoebiasis
- Metastatic infections are possible, most often from direct extension of a liver abscess
- Most commonly spreads to chest, with empyema, bronchohepatic fistula, pericarditis
- Cerebral disease is rare but can happen
Diagnosis
- Microscopically distinguishable from the non-pathogenic E. dispar, so needs molecular tests to confirm diagnosis
Management
Liver abscess
- Either
- Metronidazole 750 mg PO tid for 10 days
- Tinidazole 2 g PO daily for 5 days
- Followed by a luminal agent, either
- Paramomycin 10 mg/kg PO tid for 5 to 10 days
- Diloxanide furoate 500 mg PO tid for 10 days
Diarrhea
- Tinidazole 2 g PO daily for 5 days
- Followed by a luminal agent, as above
Asymptomatic carriage
- Treat with a luminal agent, as above
