Amoebiasis (entamoeba histolytica)

A06.9

• Description
• Diagnostic criteria
• General and supportive measures
• Medicine treatment

DESCRIPTION

Amoebic colitis is caused by the parasite Entamoeba histolytica . It can cause localised intestinal disease or disseminated disease. Amoebiasis is now relatively uncommon in South Africa, but immunodeficiency is a risk factor.

DIAGNOSTIC CRITERIA

Clinical

• Diarrhoea with mucus, blood and pus (dysentery).
• Liver abscesses:
  • presents with point tenderness over the liver area,
  • pleuritic type pain,
  • fever (often fever of unknown origin).

Investigations (colitis):

• Trophozoites or cysts in fresh stool.
• Trophozoites in rectal smear (danger of perforation if biopsy is done).
• Serological tests (ELISA and agar gel diffusion).

GENERAL AND SUPPORTIVE MEASURES

Prevent infestation by:

• Hand washing.
• Careful preparation of foods by adequate washing and cooking.

Aspirate liver abscess if not responding to treatment in 5 days or if rupture is imminent.

MEDICINE TREATMENT:

• Metronidazole, oral, 15 mg/kg/dose 8 hourly for 7 days.
  • 10 days in severe disease.