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).
Amoebiasis is widespread in many countries, especially in tropical and subtropical regions (in some of them, the prevalence of the population reaches 50–80%). Disease ranks second in the world after malaria.
Classification of amoebiasis:
- Intestinal amebiasis;
- Extraintestinal amebiasis;
- Cutaneous amebiasis.
In domestic practice, extraintestinal and cutaneous amoebiasis is regarded as a complication of the intestinal form.
Intestinal amoebiasis can occur in the form of acute, chronic recurrent and chronic continuous variants in various forms of severity.
The causative agent is an amoeba. The life cycle consists of two stages – vegetative and dormant stages (cysts), replacing each other depending on the environmental conditions. There are two forms of amoeba existence – tissue and luminal. The main role in human infection and the spread of amoebiasis belongs to amoeba cysts. Often, amebiasis is recorded as a mixed infection (together with other intestinal infectious diseases).
The source of infection is a cyst carrier or a patient with a chronic form in remission. Patients with an acute form or patients with chronic amebiasis during the period of relapse release into the external environment unstable vegetative forms of the pathogen that do not pose an epidemic danger. Carriage of luminal forms and cysts of amoeba is a widespread natural phenomenon, recorded everywhere and forming the level of infection of the population.
The mechanism of infection with amebiasis is the ingestion of feces into the mouth. Ways of transmission of amoebiasis – food, water, contact. The highest incidence of amoebiasis is recorded in tropical and subtropical climates.
The incubation period lasts from 1-2 weeks to several months.
Manifestations of the intestinal form of amebiasis
Intestinal amoebiasis is manifested by gradually increasing cramping pains in the abdomen (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 symptoms of intestinal amebiasis decrease within 4-6 weeks, but spontaneous recovery and cleansing of the body from the pathogen are rare.
In most cases, after remission, an exacerbation of the disease is recorded in a few weeks or months. In these cases, the total duration of the disease (chronic form of amebiasis) without adequate treatment is decades. This form is characterized by disorders of all types of metabolism (exhaustion, hypovitaminosis, hormonal metabolism disorders, anemia, etc.)
Extraintestinal amebiasis is characterized by damage to various internal organs. Amoebic pneumonia proceeds 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. Amebic meningoencephalitis (amoebic abscess of the brain) proceeds with manifestations of severe intoxication, focal neurological disorders; the formation of multiple abscesses is characteristic, mainly in the left hemisphere of the brain. Cutaneous amoebiasis is characterized by the formation of slightly painful ulcers with undermined 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, contents of abscesses, separated from the bottom of ulcers. A smear examination is carried out;
- Research of blood serum;
- Colon and sigmoidoscopy;
- Plain radiography;
- General blood analysis;
- Ultrasound of the liver to detect amoebic abscess.
The same symptoms can be signs of different diseases, and the disease may not proceed according to the textbook. Do not try to heal yourself – consult your doctor.
In cases of mild amebiasis is treated on an outpatient basis. Severe forms of the disease require hospitalization.
In asymptomatic and / or mild intestinal amoebiasis: quiniofon 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 next day after use alcohol).
With moderate and severe forms of intestinal amebiasis: metronidazole for 5-10 days, then a course of quiniofon or emetine 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; contraindicated in heart disease, pregnancy ).
With extraintestinal amebiasis: metronidazole – 750 mg 3 times a day for 5-10 days or emetine for 5 days (with liver amebiasis – in combination with chloroquine 600 mg / day. Inside for 2 days, then 300 mg / day within 2-3 weeks). If the pathogen is detected in the intestine, a course of quiniophone is subsequently carried out.
Untreated, amoebiasis can lead to death of the patient. With treatment, improvement usually occurs within a few days. In some patients, signs of irritation of the colon (diarrhea, cramping pain in the left lower abdomen) persist for several weeks after successful treatment of the disease. Relapses are possible.
Discharge from the hospital with complete cleansing of the intestine from the pathogen, which is established by 6-fold examination of feces taken at intervals of 1-2 days.
Surrounded by the patient, the current disinfection is carried out with a 3% lysol solution or a 2% cresol solution.