Invasive amebiasis: an update on diagnosis and management.
In its invasive form, the trophozoite is responsible for clinical syndromes, ranging from classical dysentery to extraintestinal disease with emphasis on hepatic amebiasis. Abdominal pain, tenderness and diarrhea of watery stool, sometimes with blood, are the predominant symptoms of amebic colitis. Besides the microscopic identification of Entamoeba histolytica, diagnosis should be based on the detection of specific antigens in the stool or PCR associated with the occult blood in the stool. Amebic dysentery is treated with metronidazole, followed by a luminal amebicide. The trophozoite reaches the liver causing hepatic amebiasis. Right upper quadrant pain, fever and hepatomegaly are the predominant symptoms. The diagnosis is made by the finding of E. histolytica in the hepatic fluid, or in the necrotic material at the edge of the lesion in a minority of patients, and by detection of antigens or DNA. Ultrasonography is the initial imaging procedure indicated. The local perforation of hepatic lesion leads to important and serious complications.
Salles
José Maria
JM
Federal University of Pará, Av. Visconde de Souza Franco, 1348, ZP 66053000 Belém, Pará, Brazil. salles@nautilus.com.br
Salles
Mauro José
MJ
Moraes
Luiz Alberto
LA
Silva
Mônica Cristina
MC
D000563:Amebicides / Q000627:therapeutic use; D000818:Animals; D000953:Antigens, Protozoan / Q000032:analysis; D016054:DNA, Protozoan / Q000145:classification; D003937:Diagnosis, Differential; D004404:Dysentery, Amebic / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D004748:Entamoeba histolytica / Q000276:immunology / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D008101:Liver Abscess, Amebic / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D008795:Metronidazole / Q000627:therapeutic use; D016133:Polymerase Chain Reaction
D000563:Amebicides; D000953:Antigens, Protozoan; D016054:DNA, Protozoan; D008795:Metronidazole