Prasitology - E. histolytica- SECOND MBBS STUDENTS - UNDERGRADUATE STUDENTS - MEDICAL COLLEGE - POWERPOINT

1. PROTOZOA

3.  Protozoa
 No Intermediate host
 Contamination of food and water
 Stool parasites

4.  PATHOGENIC AMOEBAE
 NON-PATHOGENIC AMOEBAE
 OPPURTUNISTIC AMOEBAE

5.  PATHOGENIC AMOEBAE:
Entamoeba histolytica
 NON-PATHOGENIC AMOEBAE:
Entamoeba coli
Entamoeba hartmanni
Entamoeba polecki
Entamoeba gingivalis
Endolimax nana
Iodamoeba butschlii

6.  OPPURTUNISTIC AMOEBAE:
Naegleria fowleri
Acantamoeba spp.,
Balamuthia mandrillaris

16.  Organelles of locomotion in Balantidium coli is Cilia
 Balantidium coli belongs to Phylum Ciliophora
 Pseudopodium is the organ of locomotion in Entamoeba
histolytica
 Phylum Apicomplexa contains Malarial parasite
 Giardia lamblia is an example of intestinal parasite

22.  Course and sequelae of Amoebic Liver Abscess
 It can rupture into lungs leading to expectoration of chocolate-
coloured sputum resulting in natural regression of abscess.
 It can rupture into the peritoneum causing peritonitis which
requires emergency laparotomy.
 It can rupture into pleural cavity leading to empyema.
 Rupture into bare area of liver causing retro-peritoneal abscess.
 Rupture into the intestines, or to the skin (Amoebiasis cutis)
 Rupture into pericardial cavity (cardiac temponade)-most
dangerous complication.
 Septicaemia and liver failure
 - See more at: http://medicinembbs.blogspot.in/2013/01/amoebic-
liver-abscess.html#sthash.z6VzcEuT.dpuf

23.  Clinical Features
 It is common in males, may be after an attack of amoebic dysentery or
many months after the attack or h/o dysentery may not be there at all.
 Pts. Present with fever, weight loss, chills and rigors.
 Pain in the right hypochondrium.
 Soft, tender, smooth liver with increased liver span.
 Intercostal tenderness
 Right sided pleural effusion may be present.
 Mild jaundice may be present esp. in cirrhotic and multiple abscesses.
 Tenderness, rigidity and skin oedema in right hypochondrium may be
present acute cases.
 In chronic amoebic liver abscess, smooth, firm/hard, nontender liver may
be palpated.
 - See more at: http://medicinembbs.blogspot.in/2013/01/amoebic-liver-
abscess.html#sthash.z6VzcEuT.dpuf

24. Investigations
Isolation of the parasite from the liver lesion or
the stool and confirming its nature by
microscopy.
Total count may be increased.
LFT may show altered bilirubin and albumin
level.
PT may be increased
Altered serum alk. Phosphatase, SGPT,
SGOT levels.
USG abdomen:
shows altered echogenicity, size, location,
number of abscess, nature of the liver.
Chest X-ray findings:
Raised fixed diaphragm
Pleural effusion
Soft tissue shadow
Positive indirect haemagglutination test
CT scan
- See more at:
http://medicinembbs.blogspot.in/2013/01/amo
ebic-liver-
abscess.html#sthash.z6VzcEuT.dpuf

25. Treatment
Tab. Metronidazole 800mg X TID or inj.
Metronidazole 500mg i.v X TID for 10 days.
I.V or oral antibiotics are essential to control
secondary infection.
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In case of large abscess and infected abscess
aspiration with a wide bore needle is done
under USG guidance after correcting the PT
and sent for c/s, cytology and for study of
trophozoites.
Surgery is done if above measure fail:
Through transperitoneal approach, abscess
area is opened, pus is evacuated and malecot’s
catheter is kept in situ until draining stops
completely, which is confirmed by repeat
USG.
- See more at:
http://medicinembbs.blogspot.in/2013/01/amo
ebic-liver-
abscess.html#sthash.z6VzcEuT.dpuf

28. ANCHOVY SAUCE PUS