Invasive amebiasis: an update on diagnosis and management.

José Maria Salles, Mauro José Salles, Luiz Alberto Moraes, Mônica Cristina Silva

Federal University of Pará, Av. Visconde de Souza Franco, 1348, ZP 66053000 Belém, Pará, Brazil. salles@nautilus.com.br

Expert review of anti-infective therapy 2007 Oct

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In its invasive form, the trophozoite is responsible for clinical syndromes, ranging from classical dysentery to extraintestinal disease with emphasis on hepatic amebiasis. Abdominal pain, tenderness and diarrhea of watery stool, sometimes with blood, are the predominant symptoms of amebic colitis. Besides the microscopic identification of Entamoeba histolytica, diagnosis should be based on the detection of specific antigens in the stool or PCR associated with the occult blood in the stool. Amebic dysentery is treated with metronidazole, followed by a luminal amebicide. The trophozoite reaches the liver causing hepatic amebiasis. Right upper quadrant pain, fever and hepatomegaly are the predominant symptoms. The diagnosis is made by the finding of E. histolytica in the hepatic fluid, or in the necrotic material at the edge of the lesion in a minority of patients, and by detection of antigens or DNA. Ultrasonography is the initial imaging procedure indicated. The local perforation of hepatic lesion leads to important and serious complications.

Citation

José Maria Salles, Mauro José Salles, Luiz Alberto Moraes, Mônica Cristina Silva. Invasive amebiasis: an update on diagnosis and management. Expert review of anti-infective therapy. 2007 Oct;5(5):893-901