Amebiasis (amebic colitis, amoebic dysentery) - an infection manifested ulcerative lesions of the colon and the development of abscesses in various organs (most often in the liver).
Amoebiasis is common in many countries, especially in tropical and subtropical regions (up to 50-80% in some of them the population prevalence). According to the World Health Organization (WHO), amoebiasis mortality level of parasitic diseases ranked second in the world after malaria.
Kinds
Amebiasis classification recommended by the WHO, 1970:
- Intestinal amebiasis;
- Extra-intestinal amebiasis;
- Cutaneous amoebiasis.
In the Soviet Union, and cutaneous extraintestinal amebiasis regarded as a complication of the intestinal forms.
Intestinal amebiasis may occur as acute, chronic recurrent and chronic continuous embodiment in various forms by gravity.
The causative agent - the amoeba. The life cycle consists of two stages - the vegetative and resting stage (cyst) succeeding one another depending on the environmental conditions. Distinguish two forms of existence amoeba - and luminal tissue. The main role of the infection and spread of human amebiasis belongs amoeba cysts. Often amoebiasis recorded as mixed infection (in conjunction with other intestinal infectious diseases).
The source of infection - patients with chronic or tsistonositel form in remission. Patients with acute or chronic amebiasis in patients relapse during the release into the environment unstable vegetative forms of the pathogen that are not of the epidemic danger. Carriage luminal shapes and amoeba cysts - a common natural phenomenon that is registered everywhere and forms the level of contamination of the population.
The mechanism of infection amebiasis - faeces into her mouth. transmission path amebiasis - food, water, pin. The highest incidence of amebiasis recorded in tropical and subtropical climates.
The symptoms of amebiasis
The incubation period - from 1-2 weeks to several months.
Manifestations intestinal amebiasis form
Intestinal amebiasis manifested gradually increasing cramping abdominal pain (predominantly left lower 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, and so on. D.)
Symptoms of extra-intestinal forms
Extra-intestinal amebiasis is characterized by lesions of various internal organs. Amoebic pneumonia occurs with inflammatory changes in the lungs and develops as a result of the introduction of the agent of the lesions in the colon or liver blood to the lungs; has a long duration, and in the absence of specific treatment may lung abscess formation. Amoebic meningoencephalitis (amoebic brain abscess) proceeds with pronounced manifestations of intoxication, focal neurological disorders; characterized by the formation of multiple abscesses mainly in the left hemisphere of the brain. Cutaneous amoebiasis maloboleznennyh characterized by the formation of ulcers with jagged edges and podrytymi malodorous ulcers form on the skin of the perineum and genitals, in fistulas and postoperative wounds.
Diagnostics
- Identification of the tissue and a large vegetative forms of the pathogen in the patient's feces, sputum, contents of abscesses, which separates the bottom of the ulcers. Spend smear;
- The study of blood serum;
- Colonoscopy and sigmoidoscopy;
- Plain radiography;
- General blood analysis;
- liver ultrasound to detect amebic abscess.
amoebiasis treatment
In cases of lung flow amebiasis treated on an outpatient basis. Severe forms of the disease require hospitalization.
- In asymptomatic and / or mild form of intestinal amebiasis: hiniofon 500 mg 3 times a day for 10-20 days, or metronidazole 750 mg three times a day for 10 days (not to be taken simultaneously or the next day after drinking alcohol).
- At moderate and severe forms of intestinal amebiasis: metronidazole for 5-10 days, followed by a course hiniofon emetine or intramuscularly not more than 5 days (the systematic control electrocardiogram; the development of tachycardia, hypotension, dermatosis drug should be discontinued; contraindicated in heart disease, pregnancy).
- In extraintestinal amebiasis: metronidazole - 750 mg 3 times a day for 5-10 days or emetine for 5 days (amebiasis liver - in combination with chloroquine 600 mg / day. orally for 2 days, then 300 mg / day. within 2-3 weeks). In identifying the pathogen in the gut in the subsequent conduct hiniofon course.
Prediction and prevention
Without treatment, amebiasis can result in death of the patient. In the treatment of improvement usually occurs within a few days. In some patients, symptoms of irritable bowel (diarrhea, Cramping pains in the left lower abdomen) persist for several weeks after successful treatment of the disease. Possible relapses.
Discharge from the hospital with complete bowel cleansing by the pathogen that set 6-fold stool examination, taken at intervals of 1-2 days.
For persons residing in the epidemic-prone region, provide for individual chemoprophylaxis universal amebotsidnogo action drugs (hiniofon, metronidazole).
In the current environment of the patient is carried out disinfection 3% Lysol solution or 2% sodium cresol.
