AMEOBIASIS: Diagnosis & Prevention
Intestinal amoebic infection is best diagnosed by microscopic examination of stool in acute amoebic dysentery;
Stool smears may reveal haematophagous amoebic trophozoites with active amoeboid movements,
but few pus cells -???.
Trophozoites have ability to lyse human neutrophils.
COLONOSCOPY AND SIGMOIDOSCOPY:
Are useful examinations to diagnose the pathological lesion,
To distinguish it from other ulcerative
Inflammatory lesions like acute bacillary dysentery Ulcerative colitis,
obtain swabs and biopsies for appropriate examinations.
The characteristic findings of amoebic dysentery are of shallow discrete ulcers with raised margins and normal intervening mucosa.
Endoscopy: with biopsies of the ulcer edge is diagnostic in 90% of cases; this is helpful for a rapid diagnosis and to differentiate amebiasis from idiopathic inflammatory bowel disease.
ULTRASONOGRAPHY:
Amoebic liver abscesses are best identified by ultrasonography.
It gives an assessment of their size and location and the distance of the wall of the abscess from the edge of the liver.
It also offers an opportunity to aspirate the cavity for examination of the pus for amoebae and for drainage.
helps in differential diagnosis between amebic liver abscess,
pyogenic bacterial abscess,
hydatid cyst,
and hepatoma.
Another simple way of diagnosing invasive amoebiasis is to detect the presence of anti-amoebic antibodies in the serum.
SEROLOGICAL TESTS:
A number of serological tests are available, the most popular being the
indirect haemagglutination assay, which is positive in over 90% of patients with amoebic dysentery
and in nearly all patients with amoebic liver abscess.
“The major difficulty is that the test remains positive for several years after initial infection, making it unreliable in distinguishing recent from past infections”.
Newer serological assays like
enzyme immunoassay appear to be as sensitive and simpler to perform.
PREVENTION:
. E. histolytica infection can be prevented by the availability of
clean water,
adequate sanitation,
and avoidance of sexual practices or living conditions that facilitate direct fecal-oral contamination.
Boiling is the only reliable way of killing cysts; chlorine solutions are not reliable.
In endemic areas, uncooked foods such as salads and vegetables should be avoided.
Stool smears may reveal haematophagous amoebic trophozoites with active amoeboid movements,
but few pus cells -???.
Trophozoites have ability to lyse human neutrophils.
COLONOSCOPY AND SIGMOIDOSCOPY:
Are useful examinations to diagnose the pathological lesion,
To distinguish it from other ulcerative
Inflammatory lesions like acute bacillary dysentery Ulcerative colitis,
obtain swabs and biopsies for appropriate examinations.
The characteristic findings of amoebic dysentery are of shallow discrete ulcers with raised margins and normal intervening mucosa.
Endoscopy: with biopsies of the ulcer edge is diagnostic in 90% of cases; this is helpful for a rapid diagnosis and to differentiate amebiasis from idiopathic inflammatory bowel disease.
ULTRASONOGRAPHY:
Amoebic liver abscesses are best identified by ultrasonography.
It gives an assessment of their size and location and the distance of the wall of the abscess from the edge of the liver.
It also offers an opportunity to aspirate the cavity for examination of the pus for amoebae and for drainage.
helps in differential diagnosis between amebic liver abscess,
pyogenic bacterial abscess,
hydatid cyst,
and hepatoma.
Another simple way of diagnosing invasive amoebiasis is to detect the presence of anti-amoebic antibodies in the serum.
SEROLOGICAL TESTS:
A number of serological tests are available, the most popular being the
indirect haemagglutination assay, which is positive in over 90% of patients with amoebic dysentery
and in nearly all patients with amoebic liver abscess.
“The major difficulty is that the test remains positive for several years after initial infection, making it unreliable in distinguishing recent from past infections”.
Newer serological assays like
enzyme immunoassay appear to be as sensitive and simpler to perform.
PREVENTION:
. E. histolytica infection can be prevented by the availability of
clean water,
adequate sanitation,
and avoidance of sexual practices or living conditions that facilitate direct fecal-oral contamination.
Boiling is the only reliable way of killing cysts; chlorine solutions are not reliable.
In endemic areas, uncooked foods such as salads and vegetables should be avoided.
Latest technology can easily identify the ameobiasis problem. Everybody should need to know more about it.
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