INTRODUCTION :-
- Amoebiasis is a parasitic,protozoan disease that effects the gut mucosa and liver, resulting in dysentery,colitis and liver abscess.
- The causative agent is Entamoeba histolytica, sapotent pathogen that is spread via ingestion of contaminated food and water.
- Globally,amoebiasis is highly prevalent and is the second leading cause of death To parasitic disease.
ETIOLOGY:-
- Contaminated food and water.
- Oral rectal contact specially among male homosexual.
- Vectors.
EPIDEMIOLOGY:-
- A worldwide distribution.
- Major health problem in the whole china, South Eastand WestAsia and latin America, specially Mexico.
- Worldwide 50 million people carry E.histolytica in their intestinal tract.
- 10%of infected people suffer from Invasive amoebiasis.
- Probable that invasive amoebiasis, accounted For about 10 lakhs deaths in the world.
- INDIA: Amoebiasis affects about 15%of the Indian Population.
SIGN & SYMPTOMS:
- Pain in the abdomen.
- Blood in stool, diarrhoea, orflatulence.
- fatigue, fever,or loss of appetite.
- Weightloss.
MODE OF TRANSMISSION:-
- Faecal oral route-Intake of contaminated food and water, vegetables & fruit
- Sexual transmission–oral rectal contact, specially among male homosexuals.
- Vectors- flies, cockroaches and rodents are capable of carrying cysts and contaminated food and water.
INCUBATION PERIOD:-
- 2-4 weeks or longer than that.
Host factor contribution:–
- Stress
- Malnutrition
- Alcoholism
- Corticosteroidtherapy
- Immunodeficiency
RISK FACTORS:-
- Travellers to developing countries.
- People who live in institutions that have poor sanitary conditions.
- HIV-positive patients.
- Homosexuals.
PATHOPHYSIOLOGY:-
Ingestion of cysts through contaminated food and water.
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Excystation in small intestin
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Division of cysts into 4 & then 8 trophozoits.
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Trophozoits moves to colonize the colo
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Encystation
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Excretion of cysts
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Ingestion of cysts by the patients.
LAB INVESTIGATION:-
- Bloodtest
- Stooltest– ELISA test
- Indirect haemagglutination test regarded as the test (IHA) is most sensitive serological test.
TREATMENT:-
1.Metronidazole- 500-750mg – oral – TID – For8-10days.
2.Tinidazole- 600mg – oral – BD– for 5days.
MOA-Kills trophozoites in intestine & tissue.
3.Iodoquinol– 650mg – oral -TID – for 10days.
4.Diloxanidefuroate–500mg – oral – TID – for 10days.
MOA–Luminal Eradicate cysts.
PREVENTION:-
Primary prevention:-
- Safe excreta disposal
- Safe water supply
- Hygiene
- Health education
Secondary prevention
- Early diagnosis
- Treatment
Red flags :-
- Dysentery
- Large intestine effect
Pearls :-
- Avoid outside unhygienic food.
REFERENCES:-
•Parasitology,K.D.Chatterjee.
•Harrison’s principals of internal medicines
•Medscape
•www.Webmd.Com