Amoebiasis (amoebic dysentery) – protozoal disease characterized by ulcerative lesions of the colon, sometimes complicated by liver abscess, pulmonary and other organs.
Causes of Amoebiasis
Pathogen – dysenteric amoeba – can occur in three forms. Large vegetative form (tissue form erythrophage) can phagocytose red blood cells and is found only in patients; luminal form and stage of cysts found in carriers of amoebas. Infection occurs by ingestion of cysts in the human digestive tract. In the large intestine the cyst turns into a translucent form comes carriage. The disease develops only in the transition luminal form in the tissue. When propagating in the tissue form the wall of the intestine have small abscesses in the submucosa, which then burst into the lumen with ulceration of the mucosa. Hematogenous dysentery amoeba may invade the liver, rarely in other organs and cause abscesses there specific. Scars occur when the healing of ulcers, can lead to narrowing of the bowel.
Symptoms of Amebiasis
The incubation period lasts from 1 week. up to 3 months. The disease begins relatively sharply. There is a weakness, headache, mild abdominal pain, liquid stool with admixtures of glassy mucus and blood. Low-grade temperature. After the acute period, usually long-term remission, acute disease then and takes a chronic course. Without antiparasitic treatment of chronic forms can last 10 years or more. They occur in a relapsing or continuous forms. Marked abdominal pain, diarrhea alternating with constipation, sometimes blood in stool. In the long asthenic syndrome develops, the decline of power, hypochromic anemia. With sigmoidoscopy revealed ulcers up to 10 mm in diameter, deep, with saped edges. The bottom of the ulcer covered pussy bloom. Ulcers surrounded by a halo of hyperemic mucosa.
Complications of amebiasis include peritonitis due to perforation of the intestine, amoeboma, intestinal bleeding. Of extra-intestinal complications more common abscess of the liver. It can develop during the acute period and after a long period of time, when there is no intestinal lesions expressed. With acute abscess appear hectic fever type, chills, pain in the right hypochondrium. Radiographically detected high standing of the diaphragm or local bulging it. Even small abscesses can be detected by scanning the liver. In chronic abscess intoxication and mild fever. Amebic abscess may burst into the surrounding organs and lead to subphrenic abscess, peritonitis, purulent pleurisy.
Laboratory confirmation of the diagnosis is the detection in the faeces of the large vegetative form of amoeba with phagocytosed erythrocytes. Often amoeba found in material taken during sigmoidoscopy with intestinal ulcers. The study should be conducted no later than 20 minutes after a bowel movement or sampling of material. There are serological methods of diagnosis.
Amoebiasis must be differentiated from dysentery, bipartidista, ulcerative colitis, cancer of the colon.
Prescribe 2% solution of emetine hydrochloride is 1,5-2 ml in/m 2 times a day for 5-7 days; in a week the cycle is repeated. In the intervals between cycles smetana appoint hingamin (delagil, chloroquine) 0.25 g 3 times a day, hiniofon (yatren) to 0.5 g 3 times a day. You can also give tetracycline 0.5 g 4 times a day, monomitsin 0.25 g 4-6 times a tribute for 5-7 days. The most effective and nontoxic drug for the treatment of patients with intestinal and extraintestinal manifestations of amebiasis believe metronidazole (trihopol, flag). Assign it to 0.5-0.75 g zrazy a day for 5-7 days. Primernih abscesses of the liver the drug is prescribed for a longer period until resorption of the abscess (filed scan of the liver). In large abscesses of the liver using surgical methods of treatment.
Prevention of amebiasis include the identification and recovery of sources of infection and the impact on distribution. Activities aimed at the source of the infection, include the identification and treatment of excreta and carriers amoebae, as well as early detection and treatment of patients with acute forms of amebiasis. Convalescent carriers are not allowed to work in the catering industry. Important value belongs to sanitary protection of the external environment from fecal contamination, strict supervision of the state of the Sewerage, toilets, cesspools, sources of water supply. Members are subject to observation during 1 year of systematic survey of them in the offices of infectious diseases. Prevention of amebiasis is the value of the broad promotion of hygienic knowledge among the population.