1. Entamoeba Histolytica
The Beast of the Bowels

2. Profile of the Pathogen
Entamoeba Histolytica is a unicellular amoeba that infects humans and lives in the lower bowels.
It’s name means bowel destroying amoeba.
It infects an estimated 50 million people worldwide
It is the third leading cause of parasitic death, surpassed only by schistosomiasis and malaria.

3. Microorganism of Malice
The 4 stages of Entamoeba Histolytica’s life are the trophozoite form, the precyst form, the cyst form and the metacyst form.

4. Protist of Perniciousness
Measures between 15 and 50 micrometers.
Reproduces primarily by binary fission
Has hyaline ectoplasm and distinct karyosome in a nucleus.
Adheres to intestinal wall via lectin an adherence lectin
Consumes erythrocytes and other somatic cells
Is capable of lysing leukocytes and evading complement-mediated lysis

5. The Cyst of Corruption
In the precyst form, the cell shrinks as it extrudes food vacuoles
The cyst forms 4 distinct nuclei, measures between 10 and 20 micrometers, and has no visible chromatoid bodies.
The metacyst is a tetranucleated amoebae without a shell around it.

6. The Circle of Calamity
The cyst forms in the bowels, and from there is passed out to the environment inside fecal matter.
From the environment, the cysts are ingested by another human host.

7. Suffering Spreads
Entamoeba Histolytica is transmitted by the fecal-oral route.
Incidence of Entamoeba Histolytica is high in developing countries with poor sewage.
The only population that shows increased incidence of Entamoeba Histolytica infection in the industrialized world is that of homosexual men.

8. The Reaping Infection with Entamoeba Histolytica is known as amebiasis
There are 2 forms of amebiasis, invasive and non-invasive

9. The Battlefield

10. The Lurking Darkness
Non-invasive amebiasis accounts for 90% of Entamoeba Histolytica infections
The symptoms include slight stomach pain and infrequent non-dysenteric diarrhea

11. Eviscerator of Viscera
Entamoeba Histolytica trophozoites penetrate the mucosa and begin to feed on the epithelial intestinal surface
This feeding causes characteristic flask-shaped ulcers of necrotic tissue in the intestines
Small ulcers grow and meet with other ulcers to cause sloughing of the intestinal wall
Sometimes the intestinal skin around the ulcer thickens, creating an ameboma

12. Torment of the Transgressor
The primary symptom is dysentery, with affected individuals sometimes suffering upwards of 20 bowel movements a day
Stool is soft, and may contain blood, mucus or pieces of intestinal epithelium
In some cases gangrene sets in within the intestines, or the intestines will rupture causing peritonitis

13. The Abomination of the Abdominal Cavity
Occasionally Entamoeba Histolytica will spread to other organs.
The most common one is the liver, which it reaches through the hepatic portal vein.
In the liver it causes abscesses, hepatomegaly and cirhosis.
Even more rarely, Entamoeba Histolytica may spread to other parts of the body such as the lungs or brain.

14. Bring out your dead…
Mortality rate in patients with uncomplicated amebic liver abscess is less than 1%
Fulminant amebic colitis has a mortality rate of more than 50%
Pleuropulmonary amebiasis has a mortality rate of 15-20% 

Amebic pericarditis has a case fatality rate of 40%
Cerebral amebiasis is highly fatal, with a 90% death rate