Intestinal Amoeba: Symptoms, Diagnosis, Treatment

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Intestinal Amoeba: Symptoms, Diagnosis, Treatment
Intestinal Amoeba: Symptoms, Diagnosis, Treatment

Video: Intestinal Amoeba: Symptoms, Diagnosis, Treatment

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Video: Amebiasis (Amoebic Dysentery) | Entamoeba histolytica, Pathogenesis, Signs & Symptoms, Treatment 2023, February
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Intestinal amoeba is a non-disease-causing microorganism that lives in the lumen of the lower part of the small and upper large intestine. It is a permanent parasitic organism, but it can exist outside of it. In the external environment, the intestinal amoeba is well preserved, in some cases it can multiply, but still a favorable place for it is the intestines of a person or other living organism. Non-living organic substrates (bacteria, remnants of various foods) are used as food, while the amoeba does not secrete an enzyme that breaks down proteins into amino acids. Due to this, in most cases, there is no penetration into the intestinal wall, which means that the owner is not harmed. This phenomenon is called carriage.With a weakening of immunity and a confluence of other circumstances, the amoeba penetrates under the intestinal mucosa and begins to multiply intensively.

Amebiasis can be recognized by the following signs: appetite decreases, general malaise appears, chronic fatigue, dehydration of the body, since a large amount of water is excreted from the body in the stool.

The content of the article:

  • 1 General information about the amoeba
  • 2 What is amebiasis
  • 3 Diagnosis of amebiasis and forms of transmission
  • 4 Symptoms of intestinal amebiasis in adults
  • 5 Symptoms of extraintestinal amebiasis in adults
  • 6 Symptoms of cutaneous amebiasis in adults
  • 7 Treatment of Amoebiasis in adults
  • 8 Symptoms and treatment of amebiasis in women
  • 9 Prevention of amebiasis

General information about the amoeba

There are two stages in the life cycle of an amoeba - vegetative (trophozoite) and cystic. The vegetative stage has its own forms: tissue, erythrophage, luminal and precystic. Amoeba in tissue form has a size of 20 - 25 microns.

What is amoeba
What is amoeba

It can only be found in acute amebiasis and only in the affected tissues. It is rarely found in feces. Amoebas in any form of the vegetative stage die very quickly in the external environment, in the feces they do not persist for more than 30 minutes.

In acute amebiasis, they are found in the feces. A characteristic feature of this form is the ability to phagocytosis (absorption) of erythrocytes. In addition, the simplest in this form can secrete enzymes and penetrate the intestinal mucosa, forming ulcers.

The transmission mechanism of amoebas is fecal-oral. This protozoan can enter the human body with water, vegetables and fruits, food. The infection can be transmitted through household items and dirty hands. Humans get infected very easily with amebiasis.

Cyst is the resting stage of the amoeba. It represents a rounded formation with a diameter of about 15 microns with a double shell. This is a very stable stage, in feces it lasts up to 30 days, in tap water - up to 60, in waste water - up to 130, on the soil surface - up to 11, and at a depth - up to 1 month. On human skin, cysts remain viable for about 5 minutes, under the nails they live much longer - up to an hour.

Intestinal amoeba is ubiquitous, but in countries with hot climates and poor social conditions, it is easier to get infected. A clinically healthy carrier of amoeba can excrete tens of millions of cysts per day with feces. And the carriers of this microorganism in the world are about 480 million.

What is amoeba
What is amoeba

Amoeba cysts that have entered the digestive tract are excised in the small intestine under the influence of enzymes, and 8 trophozoites come out of one destroyed cyst. They descend into the upper colon, where they parasitize. In the process of vital activity, amoeba again form cysts, which are excreted in the feces.

An intestinal amoeba can live in the intestines for a long time and not show itself in any way, feed on bacteria and fungi there. However, under the influence of any factors (damage to the intestinal wall, its inflammation, disturbed peristalsis), it can go into a tissue form and begin to parasitize.

Amoebas secrete enzymes that melt the tissues of the intestinal walls, destroy its mucous layer. This leads to the formation of ulcers. The amoeba goes deep into the submucous layer and multiplies there.

At the same time, the intestinal walls are restored, however, in the process, scars are formed, which can subsequently lead to intestinal stenosis. Also, in the process of scarring, pseudopolyps can form.

Intestinal amoebiasis is dangerous with complications - intestinal perforation (most often in the area of ​​the cecum), massive intestinal bleeding (due to erosions and large ulcers), amoebomas (tumor-like growths in the wall of the large intestine, consisting of fibroblasts, collagen, cellular elements and a small amount of amoebas), amoebic intestinal strictures, contributing to constipation and intestinal obstruction.

What is amoeba
What is amoeba

With blood, amoebas can enter the brain. In this case, single or multiple abscesses may develop in the brain, and the left hemisphere is more often affected. In this case, the disease ends in death.

Intestinal amoeba in a luminal form is excreted in those who have undergone acute amoebiasis or those suffering from a chronic form of this disease. It is a sluggishly moving protozoan up to 25 microns in size. The precystic form is a transitional form between the luminal stage of the vegetative form and the cyst. The amoeba is small, only 10-18 microns.

In some cases, amoebas can enter the bloodstream and are carried to other organs. Most often, amoebas enter the liver, causing liver abscesses or amoebic hepatitis.

This can happen both during acute amoebiasis and after several months. A liver abscess can cause unpleasant complications - peritonitis, lesions of the organs of the chest cavity, including amoebic peritonitis and pleuropulmonary amebiasis.

What is amebiasis

Amoebiasis is a protozoal invasion of humans, accompanied by lesions of the colon and capable of generalization.

Currently, amoebiasis is one of the largest medical and social problems in the population of developing countries and is one of the most common causes of death in parasitic intestinal diseases. After malaria, this infection ranks second in the world in the frequency of deaths from parasitic diseases.

Amoebiasis is a disease caused by pathogenic strains of Entamoeba histolytica, which are widespread in the world, mainly in countries of tropical and subtropical climates. The low level of sanitation characteristic of these areas is responsible for the high incidence of amoebiasis.

Intestinal amoeba. About 480 million people in the world are carriers of E. histolytica, 48 million of them develop colitis and extraintestinal abscesses, and 40 thousand - 100 thousand patients die. Migration, deterioration of the economic situation in a number of developing countries, low level of sanitation contribute to the spread of amebiasis and, accordingly, an increase in the incidence rate.

In Russia, amoebiasis is found in the southern regions. At the same time, due to the increasing influx of migrants from the southern regions of the near and far abroad countries, an increase in inbound tourism, as well as a significant increase in foreign tourism, including to hot climates, the incidence of amebiasis among Russian citizens, including residents of Moscow has increased significantly.

Diagnosis of amebiasis and forms of transmission

Intestinal amoeba. Infection with amoebas occurs by the oral-fecal method, often through water, vegetables, fruits contaminated with cysts.

What is amoeba
What is amoeba

Cysts in water live up to several months and are resistant to chlorine-containing drugs. Amoebic dysentery, like giardiasis, is considered a disease of dirty hands.

For a correct diagnosis, a diagnosis of the disease is necessary:

  • general analysis of blood and urine;
  • coprogram (analysis of feces for worms);
  • biochemical analyzes: bilirubin, thymol test, total protein, transaminazines (AST, ALT);
  • serological method of diagnostics: reaction of immunofluorescence (RIF), reaction of indirect hemagglutination (RNGA), reaction of enzyme-labeled antibodies (REMA);
  • a specific diagnostic method: examination of the sigmoid and rectum with an endoscope; detection of worms in smears taken during sigmoidoscopy;
  • additional diagnostic methods: radiography, ultrasound of the abdominal cavity, sigmoidoscopy, computed tomography of the abdominal cavity.

Symptoms of intestinal amebiasis in adults

Amoebiasis of the intestine is the more common form among other types of the disease, and in the literature it can be found under the name of dysentery amoebiasis.

After the amoeba enters the large intestine, it takes about 2 weeks to 3 months (incubation period) until the first clinical manifestations appear.

Symptoms of amebiasis begin gradually, not immediately. The temperature usually does not exceed 38 degrees. The very first and cardinal sign of the disease is stool disorder. At first, the feces are plentiful, arranged up to 6 times a day, then it becomes shapeless and acquires a mucus consistency.

This increases the frequency of bowel movements up to 20-30 times a day. Then blood is added to the stool, and it looks like "raspberry jelly". In addition to the violation of the stool, the patient with this form is worried about abdominal pain, which increases with the act of defecation.

In most cases, the signs of intestinal amebiasis last 4-6 weeks, after which, if no specific treatment has been prescribed, the acute form goes either into cyst carriership or into a chronic form. Both the one and the other outcome is not favorable for others, since those who have recovered are sources of infection.

Intestinal amoeba. In chronic amoebiasis, general symptoms are well pronounced. The victims have a decrease in appetite, general weakness, and deterioration in working capacity. Since the patient loses a large amount of fluid with feces, the water and electrolyte balance is very clearly disturbed.

The patient becomes dehydrated, the skin becomes dry, the face is pointed, sunken. In addition, useful substances are lost: vitamins, minerals, proteins. As a result, the patient is completely exhausted.

Symptoms of extraintestinal amebiasis in adults

The extraintestinal variety of amebiasis is formed both in the primary and in the secondary process.

What is amoeba
What is amoeba

Many organs are affected, but the most reported cases of damage to the liver, lungs and brain. The liver is the first organ other than the intestines to be targeted by the amoeba.

The signs of hepatitis are quite logical and specific to liver damage. This includes pain in the area of ​​the liver and an increase in its size. Later, when the process progresses, general symptoms of intoxication appear.

Liver abscess is a rather serious disease. It is manifested by pain in the liver and severe fever with chills. With an abscess, general signs of dehydration are very visible. There are two liver diseases: amoebic hepatitis; liver abscess.

These include weakness, dizziness, exhaustion, weight loss, lack of appetite, decreased skin elasticity, tachycardia (increased heart rate), and decreased blood pressure. In this case, the temperature is usually normal or periodically reaches 38.

When the lungs are damaged, the main symptoms of inflammation are observed - fever, chills, weakness, cough, chest pain. A lung abscess is characterized by a cough with a large amount of sputum and persistent fever.

Symptoms of cutaneous amebiasis in adults

The cutaneous form is always a manifestation of intestinal amebiasis.

What is amoeba
What is amoeba

With this form, deep ulcers form in the perianal, gluteal and perineal regions. Sometimes they can be on the hands and other parts of the body.

Ulcers and other erosions caused by amoebiasis of the skin can be observed in the perineum and buttocks, therefore, this symptom of amebiasis in women appears more often. If rashes are detected, it is strictly forbidden to take measures on their own; only a specialist can prescribe effective treatment.

Treatment of amoebiasis in adults

Intestinal amoeba. For the specific therapy of amebiasis, a large number of effective drugs have been proposed.

All drugs for the treatment of amebiasis are divided into 3 groups

Group I - drugs of direct contact action (direct amoebicides), which include quiniofon (yatren) and diiodoquine, which have a detrimental effect on the luminal forms of pathogens. They are used for the sanitation of carriers of amoebas and the treatment of chronic intestinal amoebiasis in remission.

Hiniofon is prescribed 0.5 g 3 times a day for 10 days. If necessary, after a 10-day break, another course of treatment is carried out for 10 days in the same doses. At the same time, quiniophone can be used in the form of enemas (1–2 g of the drug per glass of warm water).

Diiodoquine (diiodohydroxyquinoline) is also used for 10 days at 0.25-0.3 g 3-4 times a day.

In the treatment of complications of intestinal amebiasis, as well as amoebic liver abscess, the leading place belongs to surgical methods against the background of complex antiparasitic and pathogenetic treatment of patients. For skin amebiasis, an ointment with quiniophone is used. A wide range of pathogenetic and symptomatic therapy is required.

Group II - drugs acting on amoebas in the mucous membrane (tissue amoebocides). Effective against tissue and luminal forms of amoebas, which is used in the treatment of acute intestinal and sometimes extraintestinal amoebiasis.

Emetina hydrochloride is used in a daily dose of 1 mg / kg (maximum daily dose of 60 mg) intramuscularly or subcutaneously. Treatment is carried out in a hospital under ECG control.

Dihydroemetin is prescribed intramuscularly or subcutaneously at 1.5 mg / kg per day (maximum daily dose of 90 mg) or 1 mg / kg per day orally in the form of dihydroemetine resinate. The drug is less toxic, but as effective as emetine, it is quickly excreted in the urine.

What is amoeba
What is amoeba

Intestinal amoeba. For the treatment of patients with intestinal amebiasis, emetine and dihydroemetin are used for 5 days, for the treatment of amoebic liver abscess, the course is doubled - up to 10 days.

Ambilgar surpasses emetine and dihydroemetin in amoebicidal effect. It is used orally - at 25 mg / kg per day (but not more than 1.5 mg / kg per day) for 7-10 days.

Hingamin (delagil) has a pronounced antiprotozoal effect. It is used to treat patients with amoebic liver abscesses, as it is rapidly absorbed from the intestine and concentrated in the liver unchanged.

Hingamin therapy is carried out for 3 weeks. The drug is prescribed in the first two days of treatment, 1 g, and in all subsequent 19 days - 0.5 g per day. The drug is often combined with tetracycline.

What is amoeba
What is amoeba

Group III - drugs of universal action, which are successfully used in all forms of amebiasis. The most important representative of the group is currently metronidazole (trichopol). It is applied at 0.4-0.8 g 3 times a day for 5-8 days. Tinidazole (fasizin) is prescribed at a dose of 2 g per day for 3 days (for children, 50-60 mg / kg per day).

Furamide is used in the same cases as metronidazole, and also (due to its lower toxicity) for the chemoprophylaxis of amebiasis in foci. The course of treatment is 5 days. The drug is taken 1-2 tablets 3 times a day.

Broad-spectrum antibiotics are used as adjuvants in order to change the microbial biocenosis in the intestine. Abscesses of the liver, lungs, brain and other organs are treated surgically in combination with anti-amebic agents (usually a combination of tissue and universal amoebicides).

Treatment of intestinal amoeba is carried out depending on the severity and form of the disease. The drugs used to eliminate the disease are divided into universal amoebicides (metronidazole, tinidazole) and direct, aimed at a specific localization of the pathogen: in the intestinal lumen (quiniofon (yatren), mexaform, etc.); in the wall of the intestine, liver and other organs (emetine hydrochloride, dehydroemetine, etc.). Tetracycline antibiotics are indirect amoebicides that affect amoeba in the intestinal lumen and in its walls.

Asymptomatic intestinal amebiasis is treated with yatren. During an acute outbreak, metronidazole or tinidazole is given. In severe cases, metronidazole is combined with yatren or tetracycline antibiotics, possibly the addition of dehydroemetine. For extraintestinal abscesses, treat with metronidazole with yatren or hingamine with dehydroemetine. Dispensary observation is carried out throughout the year.

Symptoms and treatment of amebiasis in women

Intestinal amoeba. Women are particularly prone to developing amoebiasis. The objective reasons for referring to a specialist are as follows: periodic bloating (diarrhea); frequent urge to defecate; loose stools, alternating with constipation; each bowel movement is accompanied by painful sensations; pain in the right side; general weakness, apathy, lethargy.

External diagnostic signs of amebiasis in women are: coated tongue; the patient's facial features are pointed; pale skin; the sclera of the eye have an unhealthy yellowish tint; the presence of erosions or ulcerative formations in the perianal region.

Drug treatment of amoebiasis involves the use of two groups of drugs: those with which you can influence the intestinal luminal forms of invasions; tissue systemic amoebicides.

In general, all antiparasitic drugs and antiseptics, the use of which involves the treatment of amoebiasis, are divided into three functional groups: drugs to combat amoebae localized in the intestinal lumen; medicines against parasites "settled" in other internal organs; broad-spectrum drugs that effectively resist all life forms of parasites.

Intestinal amoeba. Treatment of asymptomatic carriage is carried out with luminal drugs. They are also used to prevent recurrence of intestinal amebiasis. If re-infection cannot be prevented, the use of luminal medication is not advisable.

Treatment of invasive amebiasis is carried out with tissue amoebocides - these are drugs of the 5-nitromidazole group, which are applicable both to combat the intestinal form of the disease and to treat abscesses of any other localization.

Intestinal amoeba. The drugs of the luminal group of anti-amebic drugs include: Diiodohin; Yatren; antibiotics of the tetracycline series. Such drugs affect the synthesis of proteins in the body of parasites and do not allow them to multiply. In addition, the active components of the funds block the respiration of amoebas, which will certainly lead to their death.

Prevention of amebiasis

Intestinal amoeba. Prevention of amoebiasis consists in the timely detection and proper treatment of those suffering from this disease.

What is amoeba
What is amoeba

In the risk group for the incidence of amebiasis are:

  • residents of settlements where there is no sewage system;
  • having pathologies of the gastrointestinal tract;
  • workers of food enterprises;
  • workers of children's institutions;
  • sewage treatment plant workers;
  • traveling to countries with a low socio-economic level.

These people need to periodically (once a year) be examined for the carriage of amoebas. Also, they, and everyone else, need to carefully observe personal hygiene - wash their hands, wash regularly. It is important to carefully monitor food - do not eat unwashed vegetables and fruits, do not drink raw water.

Find out more:

  • Common amoeba: structure, respiration, nutrition
  • Amoebiasis - causes, symptoms, diagnosis and treatment

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