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Published byWalter Ferguson Modified over 9 years ago
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Two morphologically identical but genetically distinct species of Entamoeba commonly infect humans. 1-Entamoeba dispar, the more prevalent species 2-E. histolytica, the pathogenic species can become invasive Infection is established by ingestion of parasite cysts.
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Cysts are resistant to environmental conditions such as low temperature and the concentrations of chlorine commonly used can be killed by heating to 55°C cyst, which is resistant to gastric acidity and digestive enzymes →excysts in the small intestine to form 8 trophozoites →colonize the lumen of the large intestine and may invade the mucosal lining.
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Food or drink contaminated with Entamoeba cysts and direct fecal-oral contact are the most common means of infection Untreated water and human feces used as fertilizer are important sources of infection.
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range from asymptomatic cyst passage to amebic colitis, amebic dysentery, ameboma, and extraintestinal disease. . E. histolytica infection is asymptomatic in about 90% of persons, but it has the potential to become invasive and should be treated Severe disease is more common in young children, pregnant women, malnourished Extraintestinal disease usually involves only the liver, but rare extraintestinal manifestations include amebic brain abscess, pleuropulmonary disease, ulcerative skin, and genitourinary lesions.
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occur within 2 wk of infection or be delayed for months colicky abdominal pains Diarrhea Stools are blood stained and contain a fair amount of mucus with few leukocytes fever documented in only ⅓ of patients incidence is strikingly high in children 1–5 yr of age amebic dysentery is associated with sudden onset of fever, chills, and severe diarrhea
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is uncommon in children. Amebic liver abscess may occur months to years after exposure. In children, fever is the hallmark and is frequently associated with abdominal pain, distention, and enlargement and tenderness of the liver.
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unremarkable in uncomplicated amebic colitis in amebic liver abscess :leukocytosis, moderate anemia, high erythrocyte sedimentation rate, and elevations of hepatic enzyme (particularly alkaline phosphatase) levels. Stool examination negative results in >50% of patients with documented amebic liver abscess. Ultrasonography, CT, or MRI can localize and delineate the size of the abscess cavity
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amebic colitis :detection of antigens in stool by ELISA examination of stool samples microscopy cannot differentiate between E. histolytica and E. dispar unless phagocytosed erythrocytes, which are specific for E. histolytica, are seen.
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Invasive amebiasis is treated with metronidazole (35–50 mg/kg/day in 3 divided doses for 7–10 days)or tinidazole (50 mg/kg/day once daily for 3 days) followed by treatment with a luminal amebicide : paromomycin(7 days), iodoquinol(20 days) OR Diloxanide furoate (7 days) Asymptomatic intestinal infection with E. histolytica should be treated with paromomycin, which is preferred, or iodoquinol or diloxanide furoate.
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