Intestinal amebiasis

How is it produced?

Entamoeba histolytica is the fourth most common infection after Chagas disease and leishmaniasis caused by a parasite. The World Health Organization (WHO) estimates that about 50 million infections by this parasite occur each year, of which about 70,000 end in death. Intestinal amebiasis occurs mainly in tropical countries and hot climates with poor hygiene or access to drinking water.

The amoeba is ingested as a cyst that found in water or food infected by feces of someone who has suffered. Cysts are very resistant forms, which can survive up to eight days in stool at temperatures between 20 and 40ºC, and for more than a month at temperatures of around 2-6ºC. The cysts are also resistant to gastric juices and to the amount of chlorine used to make the water drinkable.

Once ingested, the cyst reaches the intestine, where it opens and gives rise to the parasitic form of amoeba, called trophozoite, which enters the intestinal glands and feeds on the intestinal bolus, glandular secretions, blood and cells, destroying and inflaming the surrounding tissue. There it reproduces and forms new cysts that come out in the feces and can contaminate water and food again, thus closing the cycle.

Symptoms

Symptoms appear in one in ten patients two to three days after ingesting water or food contaminated with the cysts. Initially, the patient presents a copious stool, with liquid stools that usually present blood and mucus due to the severe intestinal inflammation caused by the parasitization. They are accompanied by severe abdominal pain and often fever. These symptoms usually resolve within a week.

There is a chronic form of parasitosis that can occur years later in which they alternate periods of profuse diarrhea with severe constipation.

Sometimes, during the acute phase of bloody diarrhea, a painful abdominal mass can be felt due to localized inflammation: this is what is called an amoeboma.

Complications of the acute phase are intestinal perforation, perianal ulcers, or the migration of amoebae to other parts of the body, where can cause abscesses, mainly at the liver level, although they can also be seen in the lungs, heart or brain.

Diagnosis

The diagnosis of intestinal amebiasis is made by observing the cysts in the stool through a microscope.

In a blood test Amoeba antibodies can be detected two weeks after infection.

If an amoeboma or liver abscess is suspected, an imaging test such as an ultrasound or an

Treatment

Treatment of Entamoeba histolytica infection will be done with the use of metronidazole if patients have symptoms. Also, electrolyte replacement is essential to prevent dehydration.

In case of abscess or ameboma they may need to be surgically removed.

Precautionary measures

The preventive measures for intestinal amebiasis are hygienic, which means that whenever you travel, you should only consume only bottled or chlorinated water and food that is cooked and in good condition. In case of presenting symptoms of this disease, it is important to go to an emergency center as soon as possible.