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Amebiasis (amoebic colitis, amoebic dysentery) is an infection manifested by ulcerative lesions of the colon and the development of abscesses in various organs (most often in the liver).
Amebiasis is widespread in many countries, especially in tropical and subtropical regions (in some of them, the prevalence of the population reaches 50–80%). According to the World Health Organization (WHO), amoebiasis in terms of mortality from parasitic diseases is the second largest in the world after malaria.
Amebiasis classification as recommended by WHO, 1970:
_ Intestinal amebiasis;
_ Extraintestinal amoebiasis;
_ Cutaneous amoebiasis.
In domestic practice, extraintestinal and skin amoebiasis are regarded as a complication of the intestinal form.
Intestinal amoebiasis can occur in the form of acute, chronic relapsing and chronic continuous variants in various forms of severity.
The causative agent is amoeba. The life cycle consists of two stages – the vegetative and the resting stages (cysts), replacing each other depending on environmental conditions. There are two forms of the existence of an amoeba – tissue and luminal. The main role in human infection and the spread of amoebiasis belongs to amoeba cysts. Often, amoebiasis is recorded as a mixed infection (together with other intestinal infectious diseases).
The source of infection is a custom carrier or a patient with a chronic form in remission. Patients with an acute form or patients with chronic Amebiasis during the relapse period emit unstable vegetative forms of the pathogen that do not pose an epidemic danger to the external environment. Carriage of luminal forms and amoeba cysts is a common natural phenomenon that is registered everywhere and forms the level of infection of the population.
The mechanism of infection with amoebiasis is the ingestion of feces in the mouth. Ways of transmission of amoebiasis – food, water, contact. The highest incidence of Amebiasis is recorded in tropical and subtropical climates.
The duration of the incubation period is from 1-2 weeks to several months.
Manifestations of the intestinal form of amoebiasis
Intestinal amoebiasis is manifested by gradually increasing cramping abdominal pains (mainly in the left lower abdomen) and frequent loose stools with a significant admixture of mucus and blood (raspberry jelly).
Fever is also characteristic, manifestations in the form of decreased performance, weakness, heart palpitations, and decreased blood pressure. Acute intestinal amebiasis is reduced within 4-6 weeks, however spontaneous recovery and cleansing of the body from the pathogen are rare.
In most cases, after remission, an exacerbation of the disease is recorded after several weeks or months. In these cases, the total duration of the disease (chronic form of amoebiasis) without adequate treatment is decades. This form is characterized by disorders of all types of metabolism (exhaustion, hypovitaminosis, hormonal metabolism disorder, anemia, etc.)
Symptoms of extraintestinal form
Extraintestinal amoebiasis is characterized by damage to various internal organs. Amoebic pneumonia occurs with inflammatory changes in the lungs and develops as a result of the introduction of the pathogen from the lesions in the colon or liver with blood into the lungs; has a long course, and in the absence of specific treatment, the formation of a lung abscess is possible. Amoebic meningoencephalitis (amoebic brain abscess) occurs with manifestations of severe intoxication, focal neurological disorders; the formation of multiple abscesses is characteristic mainly in the left hemisphere of the brain. Skin amebiasis is characterized by the formation of painless ulcers with uneven uneven edges and an unpleasant odor; ulcers form on the skin of the perineum, genitals, in the area of fistulas and postoperative wounds.
_ Identification of tissue and large vegetative forms of the pathogen in the feces of the patient, sputum, the contents of abscesses, detachable bottom of the ulcers. A study of smears;
_ Blood serum test;
_ Colon and sigmoidoscopy;
_ Survey radiography;
_ General blood analysis;
_ Ultrasound of the liver to detect amoebic abscess.
The same symptoms can be signs of different diseases, and the disease can not proceed according to the textbook. Do not try to be treated yourself – consult a doctor.
In cases of mild course, amoebiasis is treated on an outpatient basis. Severe forms of the disease require hospitalization.
In case of asymptomatic and / or mild form of intestinal amoebiasis: chiniofon 500 mg 3 times a day for 10-20 days or metronidazole 750 mg 3 times a day for 10 days (should not be taken simultaneously or the other day after use alcohol).
In case of moderate and severe forms of intestinal amoebiasis: metronidazole for 5–10 days, then a course of ciniophon or methane intramuscularly for no more than 5 days (with systematic monitoring of the electrocardiogram; with the development of tachycardia, arterial hypotension, dermatoses, the drug should be canceled; it is contraindicated for heart diseases, pregnancy )
With extraintestinal amoebiasis: metronidazole – 750 mg 3 times a day for 5-10 days or emethine for 5 days (with liver amoebiasis – in combination with chloroquine 600 mg / day. Inside for 2 days, then 300 mg / day within 2-3 weeks). If the causative agent is detected in the intestine, a chiniofon course is subsequently carried out.
Forecast and Prevention Amebiasis
Without treatment, Amebiasis can lead to the death of the patient. With treatment, improvement usually occurs within a few days. In some patients, signs of colon irritation (diarrhea, cramping pains in the lower left abdomen) persist for several weeks after successful treatment of the disease. Relapses are possible.
An extract from the hospital with complete cleansing of the intestines from the pathogen, which is established by a 6-fold study of feces taken at intervals of 1-2 days.
For those who are in an epidemiologically disadvantaged region, individual chemoprophylaxis is prescribed for drugs with universal amoebicidal action (hiniofon, metronidazole).
Surrounding the patient carry out ongoing disinfection with a 3% solution of lysol or 2% solution of cresol.