Amoebiasis, also known amoebic dysentery, is an infection caused by any of the amobae of the Entamoeba group. Symptoms are most common during infection by Entamoeba histolytica. Amoebiasis can be present with no, mild, or severe symptoms. Symptoms may include abdominal pain, diarrhea, or bloody diarrhea.

1. Discussion
Amebiasis

2. Etiology
 E dispar
 E histolytica
 E coli
 E hartmanni
 E gingivalis
 E moshkovskii
 E polecki

3.  Ingestion of cycst
 1O to 18um
 4 nuclei
 Excysted
 8 trophozoites
 Motile
 Large Intestines

4.  Trophozoites
 25um
 Single spherical nucleus
 Endoplasm contain vacuoles= RBC

5. Epidemiology
 Regional Worldwide 5 to 81%
 Tropics
 Humans = Major Reservior
 3rd leading parasitic cause of death
 Mortality Rate 4O,OOO to 11O,OOO D

6. Epidemiology
 E dispar 1O folds more common than E
histolytica
 1O% E histolytica infection = symptomatics
 1% Invasiveness
 Dissemination to other Organs less common
in Children compare to adults

7. Epidemiology
 Endemic = Africa, Latin America, India and
SEA
 US= Risk groups
 Chronically Institutionalized
 Mentally retarded c children
 Promiscuous homosexual male
 Emigrants from and traveller to endemic areas
 low socioeconomic groups

8. Epidemiology
 Fecal=Oral Route
 Untreated water
 Human feces
 Person to person transmission

9.  Young Children
 Pregnant women
 Malnourised
 Corticosteroid use
 Immunocompromised

10. Pathogenesis
 Trophozoites
 Tissue invasion and destruction
 Attached to colonic mucosa
 Galactose specific lectin recept[or
 Complement mediated lysis
 Cysteine rich proteinases
 Penetration to epithelial layer
 Direct contact = cell death
 Tissue ulceration
 local inflammatory response

11. Pathogenesis
 Spread laterally underneath Intestinal
epithelium
 Flask shaped ulcer
 Cecum
 Transverse colon
 Sigmoid colon
 Liver = abscesses

12. Clinical Manifestation
 Carrier
 Amoebic colitis
 all age groups
 1 to yrs old
 Severe = extraintestinal
 Amoebic dysentery
 Fever
 chills
 Severe diarrhea

13. • Amoeboma =abd pain and bloody diarrhea
 Nodular foci
 Inflammation
 IBD
 Intestinal wall
 Extraintestinal Disease

14. Clinical Manifestation
 Liver and Brain abscess
 Pleuropulmonary disease
 Ulcerative skin genitourinary lesion

15. Intestinal Amoebiasis
 2 weeks to a month = gradual
 Colicky abdominal pain
 LBM 6 to 8 times per day
 Diarrhea with tenesmus
 Fever undocumented
 Stool
 Blood stained
 Mucus

16. Hepatic Amoebiasis
 Diffuse liver enlargement
 Abscess = fever “Hallmark”
 Abd pain
 Distention
 tenderness

17. Hepatic Amoebiasis
 Atelectasis
 Changes of the base of R lung
 Elevation of the diaphgram

18.  Labs
 Leukocytosis
 Anemia
 Increase ESR, ALP

19.  Stool exam = 5O%
 CT, MRI = cavity
 Peritoneum and skin

20. Diagnosis
 Detection
 Stool
 Sigmoidoscopically obtained samples
 Tissue biopsy
 aspirates

21. Diagnosis
• Stool
 3
 Fresh, polyvinyl Alcohol
 Experienced
 Trophozoites = rbc
 Cyst vs trophozoites
 Dispar vs histolytica

22.  Invasive am[oebic c[o;litis
 Fecal occult blood
 Negative stools
 Biopsy
 Endoscopy

23.  Serology
 Indirect hemagglutination
 95%
 E dispar = no humural response
 Antigen =Dispar vs histolytica

24. Treatment
 All individuals

25. Treatment
 Amoebicides = gut lumen
 Iodoquinol
 Paromomycin
 Diloxanide furoate
 Metronidazole

26. Treatment
 Metronidazole
 Nitroimidazoles
 Chloroquine
 Deydroemetine

27.  Asymptomatic carriers
 Iodoquinol = 3O to 4O mg per kg,24, hours,
TID, 2O days
 Paromycin = 25 to 35 mg per kg,24, hours, TID,
7 days
 Aminoglycosides

28.  Invasive intestinal and Extraintestinal
 Metronidazole = 3O to 5O mg per kg,24, hours,
TID, 1O days
 Chloroquine
 Nausea, abdominal discomfort, and metallic
taste

29. END