Amoebiasis pathophysiology: Difference between revisions

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Revision as of 17:57, 10 March 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.

E. histolytica cyst is usually transmitted by the fecal-oral route through contaminated drinking water or food)
E. histolytica cyst may also be transmitted indirectly through direct contact with infected individuals.

Following transmission, E. histolytica trophozoites inhabit in the large intestine of the human host.
In the large intestine, the trophozoites invades the intestinal mucosa into the bloodstream. Simultaneously, they form resistant cysts in the large intestines that are then excreted in human stools.
Once in the bloodstream, the trophozoite migrates into the portal circulation and develops amebic liver abscess.

E. histolytica trophozoites secrete proteases, which induce the release of mucin from goblet cells, resulting in glandular hyperplasia.
E. histolytica is

On gross pathology, the following findings may be present in patients with amebiasis:

Wavy surface epithelium (results from focal release of mucin and spasm of the muscular layer)
Nodular and/or irregular ulcers in the cecum (most common), sigmoid colon, and rectum. Early ulcers are usually in the interglandular epithelium.

Nodular: small (sub-centrimetric), rounded, elevated lesions with necrotic center and edematous rim
Irregular: large (1-5 cm), shallow with broad elevated margins

Note: the mucosal folds may occasionally hide small colonic ulcers (false-negative results)

On microscopic pathology, amebiasis is characterized by a flask ulcer (deep, microhemorrhagic ulceration involving the submucosa), which is a characteristic of advanced disease.
Additional findings may be present in patients with amebiasis:

Invasive extraintestinal amebiasis. Adapted from Public Health Image Library (PHIL). ^[1]
Amebic abscess of liver. Adapted from Public Health Image Library (PHIL). ^[1]
Intestinal ulcers due to amebiasis. Adapted from Public Health Image Library (PHIL). ^[1]
Intestinal ulcers due to amebiasis. Adapted from Public Health Image Library (PHIL). ^[1]
Intestinal amebiasis. Adapted from Public Health Image Library (PHIL). ^[1]
Amebic abscess in liver. Adapted from Public Health Image Library (PHIL). ^[1]
Amebic abscess in liver. Adapted from Public Health Image Library (PHIL). ^[1]
Amebiasis in intestine. Adapted from Public Health Image Library (PHIL). ^[1]

@@ Line 10: / Line 10: @@
 ==Pathogenesis==
 *Following transmission, ''E. histolytica'' trophozoites inhabit in the large intestine of the human host.
-*In the large intestine, the trophozoites invades the intestinal mucosa into the bloodstream. Simultaneously, they form resistant cysts that are then excreted in human stools.
+*In the large intestine, the trophozoites invades the intestinal mucosa into the bloodstream. Simultaneously, they form resistant cysts in the large intestines that are then excreted in human stools.
 *Once in the bloodstream, the trophozoite migrates into the portal circulation and develops amebic liver abscess.