The causative agent of the disease is dysenteric ameba life which consists of two stages: vegetative (trofozit) and a resting stage (cyst). These stages are able to move from one to another, in this case depending on the environmental conditions in the body of its host.
It should be noted that the disease is endemic, respectively, characterized by the concentration for it in specifically a particular area, there is the spread in those areas, which is characterized by hot climate.
What it is?
Amoebiasis - intestinal infectious disease, has long duration and is characterized by the occurrence of ulcers of the large intestine and other organ damage.
ST Petersburg amoeba was discovered by scientists FA Leshem in 1875 in the study of patients with bloody diarrhea feces. In Egypt R. Koch (1883) identified the causative agent of intestinal ulcers and purulent cavities in the liver. Amoebiasis, called "amoebic dysentery", highlighted in a category distinct disease in 1891.
How do you get?
Amebiasis infected person can only other person has been ill, and are clinically healthy carriers of cysts. Amebiasis, as well as many other intestinal infections, can be called "disease of dirty hands".
If the cyst does not adhere to the media rules of personal hygiene, the cyst with his fecal matter can get into wastewater into the soil, in the water of open bodies of water, and then - on the grown in private households and vegetables fruits. If after using the toilet cysts carrier not washed his hands thoroughly, he can carry on cysts household items, food; Finally, it can infect another person simply by shaking hands. Not washing their hands before eating, eating unwashed fruits and vegetables, healthy man puts in his mouth cysts, where they spread further along the gastrointestinal tract.
Such a method of transmission is called fecal-oral.
form of amebiasis
Pathological changes and symptoms allow to allocate a non-invasive and invasive amebiasis. The first form is accompanied by pathological changes in the patient's body. Its characteristic features:
- symptoms of infection;
- in the endoscopic examination revealed characteristic changes in the intestinal mucosa;
- Serological tests show the presence of specific antibodies;
- the presence of parasites in the feces.
Non-invasive form of (passive) is determined as "carrier" amoebic cysts. Features:
- absence of characteristic clinical;
- absence of antibodies and pathological changes in the intestine;
- the absence of trophozoites in the feces-hematophagous.
In 90% of people infected with a non-invasive form present. These individuals are asymptomatic carriers.
The clinical picture of invasive amebiasis has a wide margin of symptoms, from mild manifestations of infection to amoebic liver abscess.
The symptoms of amebiasis
The incubation period - from 1-2 weeks to several months.
Intestinal amebiasis manifested certain symptoms: gradually increasing cramping abdominal pain (Preferably in the lower left part of the abdomen), and loose stools with considerable mucus and blood (raspberry jelly).
Characterized as fever, symptoms in the form of reduced efficiency, weakness, palpitations, lowering blood pressure. Acute intestinal amoebiasis phenomena decrease within 4-6 weeks, however spontaneous recovery and purification of an organism from the pathogen rare.
In most cases, after remission after a few weeks or months recorded worsening of the disease. In these cases, the total duration of the disease (chronic form of amebiasis) without adequate treatment - the decade. For this form of the disorder is characterized by all kinds of exchange (depletion, vitamin deficiencies, hormonal metabolism, anemia etc.)
Signs of extra-intestinal forms
From extraintestinal amebiasis most frequent manifestation is amebic liver abscess. It is characterized by single or multiple abscesses without pyogenic membrane, localized mostly in the right lobe of the liver. Disease begins acutely - a fever, hectic fever, profuse sweating, pain in the right upper quadrant, Aggravated by coughing, change in body position. The condition of patients severe liver dramatically enlarged and painful, the skin sallow hue, sometimes jaundice.
lung amebiasis proceeds or as pleuropneumonia lung abscess fever, chest pain, cough, hemoptysis. In amoebic brain abscess (amoebic meningoencephalitis) observed focal cerebral and neurological symptoms, severe intoxication. Cutaneous amoebiasis occurs secondary debilitated patients, manifested form maloboleznennyh erosions and ulcers with an unpleasant odor in the perianal area, buttocks, perineum area on the abdomen around the fistulous openings and postoperative wounds.
Diagnostics
Need a quick diagnosis of amoebiasis. The pathogen can be detected in the faeces or in tissues (e.g., sigmoidoscopy). An analysis on the detection of antibodies to the amoeba in the patient's blood. But to refer the patient to a blood test, the doctor still has to guess that the disease is caused is the simplest, but not other microorganisms.
In the waiting room do not always manage to put a correct diagnosis: the disease is too rare and symptoms are very similar to other diseases. Suspicion of amebiasis may occur immediately if the patient says that in the past two months he has been in Southeast Asia and thus its chair like a raspberry jelly.
However, on some issues to diagnose and prescribe treatment impossible. Next are diagnosed: take the analysis of feces, urine and blood. The chair can find simple and guess the amoebic infection.
Complications intestinal amebiasis form
In the event that the treatment of amoebiasis is not started in time, there is a greater likelihood of developing complications of the disease. In the blind intestine or perforation may develop rektosigmoidalnogo portion area, which leads to the peritoneal abscess or peritonitis. In some cases it may appear amoebic appendicitis and amoeboma, which represents growth of tumor in the area of direct and cecum.
Sometimes it is developing amoebic bowel stricture, which has the form of granulation tissue. Stricture is usually sporadic and are located in the area of the sigmoid and cecum. They contain amebic trophozoites and are often no symptoms. In some cases, the stricture provoke the development of constipation or intestinal obstruction.
amoebiasis treatment
All the drugs used in the treatment of intestinal amebiasis, are divided into two groups - contact and systemic tissue amebotsidy.
- First used in the presence of a non-invasive amebiasis and in the final stages of treatment to eliminate the remaining amoebas. In addition, the contact (luminal) amebotsidy demand in those cases when it is necessary to take preventive measures to prevent the spread of infection. For drugs in this group include: etofamid, paromomycin, klefamid, diloxanide.
- When the diagnosis of invasive amebiasis, treatment involve administration of systemic tissue amebotsidov - metronidazole, secnidazole, tinidazole. In severe forms amebiasis recommended antibacterials active against intestinal microflora.
Developed abscesses (more than 6 cm) in need of aspiration (percutaneous drainage). This procedure is necessary to prevent rupture of the abscess, and in cases where the ulcer chemotherapy does not lead to the expected results. Corticosteroids for patients with a diagnosis of amoebiasis - are contraindicated, since they are accompanied by numerous complications.
In general, provided adequate early diagnosis and drug therapy, intestinal amebiasis completely cured within a few months after initiation of treatment.
