[Autochthonous amebic liver abscess in Spain: an emerging disease? Case report and description of a PCR-based diagnostic test].
BACKGROUND
In Spain an increase in cases of amebiasis has been detected in patients with no history of traveling to, or immigration from, endemic areas.


METHODS
This study describes two new cases of amebic hepatic abscess due to native protozoa and reviews 21 more cases of amebic hepatic abscess reported in Spanish patients who had never left the Iberian Peninsula. In addition, a new PCR-based technique for diagnosing Entamoeba histolytica is described.


RESULTS
Twenty cases (87%) occurred in men. The age range of the affected patients was 26 to 77 years. Two of the 3 women with extraintestinal amebiasis were HIV-positive. There was no history of exposure to the parasite in 17 cases. In the remaining 6 cases, direct contact with patients affected with amebiasis or with individuals or foods from endemic areas was recorded.


CONCLUSIONS
Entamoeba histolytica infection is becoming an emerging disease in our country. Amebiasis should be included in the differential diagnosis of consistent clinical entities even when there is no background of traveling or immigration. New molecular diagnostic tools can help to characterize this infection and should be considered reference techniques in combination with serological methods.
Servicio de Parasitología, Centro Nacional de Microbiología, ISCIII, Madrid, España. mjguti@isciii.es
María José
MJ
Gutiérrez-Cisneros
Pablo
P
Martín-Rabadán
Luís
L
Menchén
Juan Manuel
JM
García-Lechuz
Isabel
I
Fuentes
Teresa
T
Gárate
Emilio
E
Bouza
D000328:Adult; D000368:Aged; D000563:Amebicides / Q000627:therapeutic use; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D002738:Chloroquine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000453:epidemiology*; D016054:DNA, Protozoan / Q000032:analysis; D004322:Drainage; D004748:Entamoeba histolytica / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D005260:Female; D005506:Food Contamination; D016266:Food Parasitology; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008101:Liver Abscess, Amebic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery / Q000635:transmission; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D010303:Paromomycin / Q000627:therapeutic use; D016133:Polymerase Chain Reaction / Q000379:methods*; D013030:Spain / Q000453:epidemiology
D000563:Amebicides; D000913:Antibodies, Protozoan; D016054:DNA, Protozoan; D008795:Metronidazole; D010303:Paromomycin; D002738:Chloroquine