Entamoeba histolytica: Difference between revisions
From IDWiki
Entamoeba histolytica
No edit summary |
(added management) |
||
| Line 29: | Line 29: | ||
* 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 |
||
| + | == Management == |
||
| + | === Liver abscess === |
||
| + | * Either |
||
| + | ** [[Is treated with::Metronidazole]] 750 mg PO tid for 10 days |
||
| + | ** [[Is treated with::Tinidazole]] 2 g PO daily for 5 days |
||
| + | * Followed by a luminal agent, either |
||
| + | ** [[Is treated by::Paramomycin]] 10 mg/kg PO tid for 5 to 10 days |
||
| + | ** [[Is treated by::Diloxanide furoate]] 500 mg PO tid for 10 days |
||
| + | |||
| + | === Diarrhea === |
||
| + | * [[Is treated by::Tinidazole]] 2 g PO daily for 5 days |
||
| + | * Followed by a luminal agent, as above |
||
| + | |||
| + | === Asymptomatic carriage === |
||
| + | * Treat with a luminal agent, as above |
||
{{DISPLAYTITLE:''Entamoeba histolytica''}} |
{{DISPLAYTITLE:''Entamoeba histolytica''}} |
||
[[Category:Protozoa]] |
[[Category:Protozoa]] |
||
Revision as of 14:37, 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
