Amoebiasis

Causes and symptoms of amoebiasis

---

What is the amoebiasis?

Amoebiasis refers to a protozoa infectious disease and is characterized by ulcerative lesions of the colon. For lesions peculiar appearance of abscesses in different organs and the tendency to chronic and lingering form of flow. This disease is endemic to specific areas, and is distributed in areas with a hot climate.

Causes of amebiasis

The causative agent of the disease is Entamoeba histolytica, a life which consists of two stages: vegetative (trofast) and the resting stage (cyst). These stages are able to transition from one to the other, while depending on the habitat conditions in the body of its carrier.

Currently there are three forms of dysenteric amoeba:

1. Large vegetative form is a pretty large and quite moving amoeba, which is found during the acute stage of the disease and during exacerbations in lumps of stool, composed of blood and mucus.

2. Small vegetative form of amoeba can be detected in the stool of patients at the conclusion of acute amoebiasis. It is characterized by a smaller mass and mobility in comparison with the large vegetative form. In addition, this form supports testoobraznoj.

3. The cyst has an oval shape, covered with a dense shell and has 1-4 nuclei. All vegetative forms of amoeba can't exist without a human body, so in its absence quickly die. Cysts are also well tolerated by the environment, consequently, is able to persist in the faeces for up to four weeks in water, the period is extended to eight months, which can cause epidemics. During the drying process of the cysts are rapidly killed.

The source of the disease may be the patient of chronic and acute amoebiasis, tectonical and a recovering patient. Of transmission the most common is fecal-oral, to the more rare include food, contact-domestic and waterways. The source of infection may be food, in particular fruits and vegetables, water, linen, toys, dishes and other household items. The spread of the cyst contribute to cockroaches and flies.

Human infection by the amoeba takes place exclusively through the mouth, and only cysts, which get into the stomach with pancreatic juice shed your shell and transform into vegetative forms, and then penetrate the wall of the colon and cause the ulcerative process. Ulcers, usually quitedeep, can penetrate to serous cover, which may result in perforation of the intestinal wall.

Hematogenous dissemination of amoebas is the reason for the development of extraintestinal amebiasis, with perhaps the formation of abscesses in such organs as the liver, lungs, brain, etc. the Chronic form of amebiasis contributes to the formation of cysts, ameba and polyps. Ameboma is education in the form of a tumor in the wall of the colon.

Getting amoebiasis can a man of any age, however, the risk group includes men 20-50 years.

The symptoms of amebiasis

Entamoeba histolytica is mostly striking in the intestinal mucosa. As a result of inflammatory process are formed ulcers, the diameter of which ranges from 2 to 2.5 mm . Pus covers the bottom of these ulcers. In the most severe cases, can occur with perforation of the intestinal wall, as well as the development of purulent peritonitis. The healing process of ulcers may cause proliferation of connective tissue, stenosis, and in rare cases can cause complete obstruction of the intestine.

Amoebas can spread hematogenous, leading to amebiasis outside of the intestine. According to statistics, the risk of the most exposed to the liver, where there are pockets of necrosis, which, after abstenerse. In addition, amoebic abscesses develop in the skin, lungs, brain and other organs.

There are three main forms of amebiasis: intestinal and extraintestinal skin.

The most frequent form of the disease is intestinal amebiasis, also called amebic dysentery. The incubation period lasts from 1-2 weeks to three months. The disease is characterized by mild, moderate and severe forms.

The health of patients is characterized most often as satisfactory. Body temperature is usually normal, an increase occurs rarely. Intoxication is not observed. Patients may complain of slight weakness, malaise, fatigue, intermittent pain in the abdomen and loss of appetite.

The main symptom of the disease is a disorder of the chair. On the first day stool feces with mucus, abundant, with a frequency of 4-6 times a day. After the frequency of bowel movements is increased up to 10-20 times a day. Loses fecal character, acquired a glassy mucus, then add a bloody discharge, and bowel movements become crimson. For acute forms of amoebiasis characterized by constant cramping abdominal pain.

With the defeat of the rectum appear painful tenesmus. During palpation the abdomen is soft and painful in the course of the colon.

The acute form of the disease lasts no longer than 4-6 weeks. After that, even in the absence of treatment, the totalthe patient's condition improved, and kriticheski syndrome relieved. The process of remission can last from several weeks to several months. Then there is the return of the main part of the symptoms of amebiasis and the disease manifests itself in the chronic form.

The duration of chronic amebiasis without treatment can be several decades. There is a possibility of recurrence and ongoing symptoms.

During recurrent illness interspersed with periods of remission, during which improvement of the General condition of the patient.

For continuous forms of amoebiasis is characterized by the absence of remission, and the disease is then increased, with alleviation of symptoms.

In chronic amebiasis can develop asthenic syndrome. Patients lose weight, have a reduced appetite and a bad taste in your mouth.

During the exacerbation the number of bowel movements can vary from 20 to 30 times a day. Pain is absent or expressed very weakly. The abdomen is usually retracted. You can observe the symptoms pointing to such disorders of the cardiovascular system as tachycardia and muted tones of the heart. Possible pain and slight liver enlargement. For very advanced cases characterized by exhaustion, which leads to death.

Intestinal form of amebiasis can cause many complications, among which one should highlight pericolic, gangrene of the mucosa, bleeding, perforation of the intestinal wall with subsequent peritonitis, acute specific peritonitis, rectal prolapse, strictures (prolapse) of the intestine.

Among the extraintestinal forms of amebiasis the most common is amoebiasis of the liver, which can occur due to intestinal amebiasis. Characterized by acute or chronic form of disease. Also has two forms: amoebic hepatitis and liver abscess.

For amoebic hepatitis characteristic pain in the right hypochondrium, compaction and enlargement of the liver, slight increase in temperature. Jaundice may be absent.

For liver abscess tend these same symptoms. The difference lies only in the fact that the pain in the right hypochondrium is more intense, and they are aggravated by change of body position and deep breathing. Patients complain of sweating, and weakness.

Suffering from the disease people look skinny, have a pointed face and reduced skin turgor. Skin different earthy hue, in some cases, you may develop jaundice. The cardiac system is characterized by the muted tones of the heart, decrease in blood pressure, tachycardia.

Amoebic liver abscesses complicated by purulent formsperitonitis, pleurisy, pericarditis. The mortality rate among patients with greater than 25 %.

During amebiasis may develop amoebic pneumonia and lung abscess. There are cases of amoebic processes of the kidneys, spleen and female genital organs.

Amebiaz skin can cause erosions and ulcers of the buttocks and perineum.

Treatment of amebiasis

For the treatment of such diseases as amebiasis used a variety of drugs, which are divided in turn into three groups.

The first group – drugs direct contact action that kills the pathogen.

These include dyadkin and Atren. Last take 0.5 grams 3 times day, course of treatment is 10 days, if necessary, treatment can be repeated.

Dyadkin appoint 0.25–0.3 gram 3-4 times a day. The period of the drug is 10 days.

The second group are drugs that act on the tissue forms of the parasite. Used in intestinal and extraintestinal amoebiasis.

Emetine hydrochloride. The dose per day is 1 mg/kg Subcutaneous and intramuscular injections are given within 5-6 days. A course can be repeated after 45 days.

Degidroemetin. The dose per day is 1.5 mg/kg Subcutaneous and intramuscular injection was carried out for 10 days. The course may be repeated if necessary after 45 days. This drug is not as toxic as emetine.

Amberger (perinatal) more effective than emetine and dehydroemetine. It must be applied at 25 mg/kg for 7-10 days. Side effects are manifested in the form of headache and psychical disorders.

Delagil (chloroquine, resochin) has pronounced antiparasitic action. It is rapidly absorbed in the intestine and concentrates in the liver, prescribed for intestinal amoebiasis and liver abscess, was adopted by the following within three weeks:

1 week – 0.75 g a day

2 weeks – 0.5 g a day

3 weeks – 0.25 g a day.

Treatment with delagil: first 2 days – 1 gram a day, the remaining 19 days – 0.5 grams per day.

The third group includes drugs that are effective in all forms of amoebiasis.

Assigned metronizadol (glaygl, trihopol). Intestinal amoebiasis: 0.4 grams 3 times a day for 5days. Extraintestinal amoebiasis: the first day is 0.8 grams, 3 times a day, the remaining 5 days – 0.4 grams 3 times per day. Some use courses of metronidazole last for 10 days.

Pyramid is used to prevent amebiasis. The course of treatment is 5 days. Need to take 2 tablets 3 times a day. For the prevention of disease when the risk of infection make the drug should be 2 tablets a day.

Also applied broad-spectrum antibiotics, but only as auxiliary substances, this should include tetracycline, methacycline monomitsin, and others. In addition, when abscesses of the liver, brain, lungs and other organs, they are taken protivosemnye drugs – for example, if the amebiasis of skin ointment is used with atrena.

Need symptomatic and pathogenetic therapy.

If the patient develops anemia, prescribers with a high iron content and blood substitutes, in rare cases, hemotransfusion. Be sure to adopt a complex of vitamins: vitamins of group b, ascorbic acid.

In severe form of amebiasis is infusion therapy, ie, intravenous introduced reopoliglyukin, glucose-saline solutions, and so on.