Intestinal Amoebiaza

Intestinal Amoebiaza

    * Introduction
    * Pathogenesis and causes
    * Signs and symptoms
    * Diagnosis
    * Treatment
Ameobiaza caused by Entamoeba histolytica is a ubiquitous protozoan. The increased prevalence is found in developing countries where the barriers between human feces and food and water deposits is inadequate. Although most cases are asymptomatic amoebiaza, massive dysentery and extraintestinal disease may occur. Amoebic liver abscesses are the most common manifestations in amoebiaza invasive, but may be involved and other organs, such as pleuropulmonul, heart, brain, kidney, genitourinary tract and skin locations. In developed countries, amoebiaza affects mainly immigrants and travelers in endemic regions, gays and immunosuppressed persons or institutions.
Entamoeba histolytica is transmitted through ingestion of cysts (stage infection) protozoa. Viable in the environment for weeks or months, the cysts are found in soil contaminated with feces, fertilizer or water, as well as on contaminated hands or food. Fecal-oral transmission may also occur in the anal-sex practices or through devices that direct inoculation of irrigation colony. Exchistarea occurs in the terminal ileum or colon resulting trofozoizii-invasive form. Trofozoizii barrier can penetrate and invade the lining of the colon leading to tissue destruction, secretory diarrhea and colitis with similar blood inflammatory bowel disease. In addition trofozoizii marrow can be spread via the portal circulation to the liver or distant organs.
Entamoeba species infects about 10% of the world. The prevalence of infection is 50% in parts of South America, Africa or Asia. Asymptomatic infections tend to be dependent on the region. Travelers in endemic areas are at risk of infection, 10% of people returning with diarrhea. Liver abscesses were reported in expunerele amoebiazice travels less than four days, while amoebic colitis is rare to travel on short notice.
Amoebiaza asymptomatic should be treated with antibiotics to eradicate the infection. Amoebic colitis treated with metronidazole and an intraluminal agent to eradicate the infection. Liver abscesses are cured with metronidazole without drainage. Amoebiaza disseminated should be treated with metronidazole, which can pass the blood-brain barrier. Surgery is indicated in the failure of antibiotic therapy, empyema, liver abscess large abscess rupture, abscess superinfection. Abscess drainage in uncomplicated cases is not necessary.
Amoebiaza is second only to malaria protozoa associated mortality. The combined prevalence of amoebic colitis and liver abscess is estimated at 40-50 million cases annually worldwide, with 100. 000 deaths. Amoebiaza bowel symptom occurs in 90% of those infected. Yet only 4-10% of these people have developed colitis or extraintestinal disease. Fatality rate associated with amoebic colitis ranges from 1. 9-9. 1%. amoebic colitis progresses to fulminant necrotizing colitis, or rupture at 0. 5% of cases. In such cases, mortality is 40%. Liver abscess mortality rate decreased to 1-3% after the introduction of effective medical treatment. They can be complicated by intraperitoneal rupture of the 2-7% of patients leading to increased mortality.