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{{Amoebiasis}}{{CMG}}
{{Amoebiasis}}{{CMG}}
==Overview==
==Overview==
==Natural History, Complications and Prognosis==
==Natural History==
===Natural History===
===Luminal Amoaebiasis (Asymptomatic) - 1 to 3 Weeks===
[[Image:Entamoeba histolytica life cycle-en.svg|thumb|left|250px|Life-cycle of the ''[[Entamoeba histolytica]]'']] 
*Following transmission, individuals remain asymptomatic for approximately 1 to 3 weeks, during which the parasite starts to actively destroy to integrity of the intestinal wall.
Infections can sometimes last for years. Symptoms take from a few days to a few weeks to develop and manifest themselves, but usually it is about two to four weeks.
*The majority of patients with ''Entamoeba'' (both ''E. dispar'' and ''E. histolytica'') do not develop any clinical manifestations.  
Onset time is highly variable and the average asymptomatic infection persists for over a year. It is theorized that the absence of symptoms or their intensity may vary with such factors as strain of amoeba, immune response of the host, and perhaps associated bacteria and viruses.
*The infection rate of ''E. histolytica'' is approximately 20%, whereas the infection rate of ''E. dispar'' is approximately 0%.


===Complications===
===Invasive Intestinal Amoaebiasis===
In the majority of cases, amoebas remain in the gastrointestinal tract of the hosts. Severe ulceration of the gastrointestinal mucosal surfaces occurs in less than 16% of cases. In fewer cases, the parasite invades the soft tissues, most commonly the liver. Only rarely are masses formed (amoebomas) that lead to intestinal obstruction.
*As the parasite continues to invade the intestinal wall, the integrity of the wall is compromised, and the host immune cells are activated. The activation of neutrophils, macrophages, lymphocytes, and eosinophils contribute to inflammation and the development of clinical manifestations.
*Early symptoms include profuse, watery diarrhea, abdominal pain, bloating, and nausea.
If left untreated, patients may progress to develop dysentery, colitis, appendicitis, toxic megacolon, and ameboma.
 
===Invasive Extraintestinal Amoebiasis===
*As the infection advances, the parasite is able to migrate outside the intestinal lumen into the bloodstream, where it is able to migrate to distant organs.
*If left untreated, the most site of parasitic migration is the liver, whereby the parasite travels in the portal circulation and causes amoebic liver abscess.
*Other organs may also be affected, including the brain (brain abscess), pulmonary system (pleuropulmonary abscess), skin, and genitals.
 
==Complications==
Complications of amoebiasis may be either intestinal or extraintestinal:
===Intestinal Complications====
*Dysentery
*Colitis
*Appendicitis
*Toxic megacolon
*Ameboma
 
===Extraintestinal Complications===
*Amoebic liver abscess
*Amoebic brain abscess
*Pleuropulmonary abscess
*Skin lesions
*Amoebic genital lesions
*Cardiac abscess
 
==Prognosis==


''Entamoeba histolytica'' infection is associated with malnutrition and stunting of growth.<ref>{{cite journal | author=Mondal D, Petri Jr WA, Sack RB, ''et al.'' | title=''Entamoeba histolytica''-associated diarreal illness is negatively associated with the growth of preschool shildren: evidence from a  prospective study | journal=Trans R Soc Trop Med H | year=2006 | volume=100 |issue=11 | pages=1032&ndash;38 | doi=10.1016/j.trstmh.2005.12.012 }}</ref>
;Other complications
*[[Liver abscess]]
*[[Medication]] [[side effects]], including [[nausea]]
*Spread of the [[parasite]] through the [[blood]] to the [[liver]], [[lungs]], [[brain]],  or other [[organs]]
===Prognosis===
* The outcome is usually good with [[treatment]].


==References==
==References==

Revision as of 21:36, 11 March 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Natural History

Luminal Amoaebiasis (Asymptomatic) - 1 to 3 Weeks

  • Following transmission, individuals remain asymptomatic for approximately 1 to 3 weeks, during which the parasite starts to actively destroy to integrity of the intestinal wall.
  • The majority of patients with Entamoeba (both E. dispar and E. histolytica) do not develop any clinical manifestations.
  • The infection rate of E. histolytica is approximately 20%, whereas the infection rate of E. dispar is approximately 0%.

Invasive Intestinal Amoaebiasis

  • As the parasite continues to invade the intestinal wall, the integrity of the wall is compromised, and the host immune cells are activated. The activation of neutrophils, macrophages, lymphocytes, and eosinophils contribute to inflammation and the development of clinical manifestations.
  • Early symptoms include profuse, watery diarrhea, abdominal pain, bloating, and nausea.

If left untreated, patients may progress to develop dysentery, colitis, appendicitis, toxic megacolon, and ameboma.

Invasive Extraintestinal Amoebiasis

  • As the infection advances, the parasite is able to migrate outside the intestinal lumen into the bloodstream, where it is able to migrate to distant organs.
  • If left untreated, the most site of parasitic migration is the liver, whereby the parasite travels in the portal circulation and causes amoebic liver abscess.
  • Other organs may also be affected, including the brain (brain abscess), pulmonary system (pleuropulmonary abscess), skin, and genitals.

Complications

Complications of amoebiasis may be either intestinal or extraintestinal:

Intestinal Complications=

  • Dysentery
  • Colitis
  • Appendicitis
  • Toxic megacolon
  • Ameboma

Extraintestinal Complications

  • Amoebic liver abscess
  • Amoebic brain abscess
  • Pleuropulmonary abscess
  • Skin lesions
  • Amoebic genital lesions
  • Cardiac abscess

Prognosis

References


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