Amoebiasis or Amoebic Dysentery: Symptoms, Causes, and Diagnosis
Amoebiasis, or amoebic dysentery, is an intestinal infection in which the parasite E. histolytica infects the intestines. Single-celled parasites known as entamoeba can infect both humans and some animals. At least six different entamoeba species may infect the human intestine, but only E. histolytica can cause disease. Amoeba is found in moist habitats, including dirt, water, and other places. They move and feed using flowing extensions of their bodies, known as pseudopodia. Amoebae are types of germs (protozoa). Protozoa is a more general name for microscopic, single-celled organisms. E. histolytica lives in the gut of infected people. It can be passed out from their stools.
These parasites live in or on another organism and can survive for weeks or months in soil, fertilizers, or water contaminated with infected feces. If someone eats or drinks infected food or drinks, they could get sick and spread the disease to others. E. histolytica can enter the bloodstream from the gut in certain people and circulate to the liver, lungs, and possibly other organs.
Symptoms
The majority of people who have this parasite will not exhibit any symptoms. Those who do get ill might have minor or major signs. The mild kind of amoebiasis includes
- Nausea,
- Diarrhea
- Unexpected Weight loss,
- Stomach tenderness,
- Occasional fever
Sometimes, the parasite will spread from the intestines, resulting in a more severe infection, such as a liver abscess. After exposure, symptoms may appear from a few days to a few months, but often between two to four weeks.
When To See Doctor?
Consult the doctor immediately if anyone in your family has symptoms of amoebiasis, such as:
- Diarrhea with blood or mucus,
- Diarrhea that lasts longer than two weeks,
- Abdominal pain
- fever
- Pain or tenderness below the ribs on the right side
Tell your doctor if you visited a part of the world where amoebiasis is common. Also, suppose your kid has diarrhea and dehydration symptoms, including dry or sticky lips, less frequent urination, no tears while crying, dizziness, or sleepiness. In that case, you should get in touch with your doctor immediately.
Causes
A single-celled protozoan called E. histolytica often enters a person's system when they ingest cysts via food or water. It can also enter the body by coming in touch with feces directly.
The parasite is a relatively inactive cyst that can survive for several months in the atmosphere or soil where they were deposited in feces. Microscopic cysts can be detected in polluted water, fertilizer, or soil.
When preparing food, kitchen staff run the risk of spreading cysts. Additionally, transmission is possible during colonic irrigation, oral-anal sex, and anal intercourse.
Cysts that enter the body dwell in the digestive system, and the parasite's invasive, active form, known as a trophozoite, is then released. The parasites multiply in the gastrointestinal system before moving to the large intestine, and they can penetrate the colon or intestinal wall therein.
Risk factors
The risk factors usually include:
- Traveling to or living in an area with a high incidence of amoebiasis, such as developing countries.
- Poor sanitation
- Lack of clean drinking water.
- Eating or drinking contaminated food or water.
- Close contact with an infected person.
- Lack of personal hygiene.
- Poor handwashing practices.
- Having a weakened immune system.
- Having a chronic disease such as diabetes or HIV.
- Using antibiotics which can disrupt the balance of gut bacteria.
- Consuming raw or undercooked meats, particularly pork.
- Consuming raw fruits and vegetables that have been washed in contaminated water.
- Consuming unbottled or tap water in high-risk areas
- Working or living in crowded conditions.
- Eating unhygienic street foods
- Having a history of diarrhea or other intestinal infections
- Consuming raw shellfish or other seafood
- Consuming fermented or pickled foods
- Working as a food handler or in a food-processing facility
- Using recreational drugs that are taken orally
- Having a history of poor nutrition
Complications
Amoebic liver abscesses are the most common amoebiasis complication, which is non-intestinal. These may result in symptoms like-
- Fever
- Pain in the right uppermost part of the abdomen
- Jaundice.
Amoebiasis can, in rare circumstances, impact the respiratory system, leading to a collapsed lung. Empyema or a hepato-bronchial fistula can develop due to ruptured amoebic liver abscesses. Their typical symptoms include:
- Coughing
- Fever
- Difficulty breathing
Although possible, amoebiasis can induce cardiac issues, which is often rare. Amoebiasis can, in very rare cases, lead to amoebic brain abscesses. These can cause the following symptoms:
Prevention
Amoebiasis can be prevented by practicing good hygiene. Wash the hands thoroughly with soap and water before preparing food and after using the restroom. If you're visiting places where the infection is common, prepare and eat your food according to the following schedule:
- Fruits and vegetables should be thoroughly washed before eating.
- Use sealed bottles for soft drinks and bottled water.
- In order to drink tap water, boil it for at least one minute before drinking.
- Avoid using ice cubes or fountain drinks.
- Avoid drinking unpasteurized milk, cheese, or other dairy products.
- Avoid unhygienic food sold by street vendors.
Diagnosis
After understanding your current health and travel history, your doctor may detect amoebiasis. It can be challenging to diagnose because E. histolytica looks like other parasites, such as E. dispar. Your doctor may suggest stool examination and antigen testing to identify E. histolytica and rule out other potential infections.
Exams and Tests
The following tests are done to check the presence of E. histolytica:
- Most commonly, you might be asked to submit stool samples every few days for testing for the parasite. This is because there may be more amoebas than a single stool sample can identify, which might vary daily.
- To find E. histolytica antigens, a stool test known as the ELISA (enzyme-linked immunosorbent assay) is frequently used.
- To identify E. histolytica from other infections, a molecular polymerase chain reaction (PCR) test can be run using a blood sample or nose swab.
- Your doctor may also request blood testing to detect whether the infection has spread from your intestines to another organ, such as your liver.
- The parasites may disappear from your feces once they spread outside the gut. To look for lesions in your liver, your doctor could recommend an ultrasound or CT scan.
- Your doctor might need to do a needle aspiration if lesions develop to see whether the liver has any abscesses. Amoebiasis can have significant side effects, including liver abscesses.
- Lastly, a colonoscopy may be required to determine whether the parasite is present in your large intestine (colon).
Treatment
The treatment generally consists of the following:
- If you experience symptoms, you should take a 10-day course of the antiamoebic medication metronidazole in tablet form.
- If you need it, your doctor might recommend a nausea-controlling medication.
- Antibiotics may be used to treat you if you don't display any symptoms.
- The treatment must target the parasite and infected organs.
- If the peritoneal tissues or colon have perforations, surgery might be required.
| Antimicrobial Therapy | Amoebic liver Adscess | Intestinal Amoebiasis |
| Metronidazole | 750-800mg three times daily for 5-10 days | 750-800mg three times daily for 5-10 days |
| Tinidazole | 2 g daily for 5 days | 2 g daily for 3 days |
| Paromomycin | - | 25-35 mg/kg per day divided into three doses, for 7 days |
| Diloxanide Furoate | - | 500mg three times for 10 days |
Consult your doctor before taking the above medicines.
Do's And Don'ts
Amoebiasis can also affect other organs, resulting in life-threatening consequences, including liver abscesses. To avoid problems and the spread of the illness, prompt identification, and treatment are essential. The following are many dos and don'ts that one might adhere to in order to prevent the harmful effects of amoebiasis.
| Do’s | Don’ts |
| Wash the hands thoroughly with soap and water, especially after using the toilet. | Consume food or water that may be contaminated with fecal matter. |
| Cook food thoroughly and consume it while it is still hot. | Consume raw or undercooked meats. |
| Wash fruits and vegetables properly before eating them. | Share personal items such as towels or toothbrushes with others. |
| Seek medical help if you have symptoms of amoebiasis. | Self-medicate with over-the-counter medications or antibiotics. |
| Take all prescribed medications as directed by the doctor. | Have sexual contact with someone with amoebiasis. |
Care at Medicover Hospitals
At Medicover hospitals, we work with the greatest, most well-renowned General physicians & medical staff members to provide our patients with the best possible treatment while being compassionate and caring. With the active participation of healthcare professionals from several departments, each with their own area of specialty, we treat amoebiasis holistically to provide complete care, improve recovery, and promote overall health. Our world-class medical professionals accurately identify the condition and provide therapeutic interventions.
