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PubMed1984

[Hepatic amebiasis: study of 152 cases].

The purpose of this study was to describe and analyse retrospectively the clinical, serological, anatomical and evolutive features of 152 cases of hepatic amebiasis in young adults, treated and followed up in France from 1969 to 1983. The disease was revealed 3 times out of 4 by tender hepatomegaly with fever, but only in 6 cases by complications. Serological tests (immunofluorescence or hemagglutination) were always positive for amebiasis, whereas Entamoeba histolytica was absent from stools in 96.7 p. 100 of the cases. Hepatic amebiasis always caused a hepatic abscess: in these cases, the superiority of ultrasonography over all other diagnostic methods was confirmed, especially concerning the detection of multiple abscesses (47 p. 100). Complete recovery was obtained by medical treatment in 117 cases, either alone (98 cases), or combined with needle aspiration (19 cases). Nitro-imidazoles are the simplest treatment, but nevertheless in 5 cases they were not effective. These patients were then treated with dehydroemetine, associated in 2 cases with surgery. Four patients relapsed at mid or long-term after apparent recovery, in the absence of any obvious reinfection. A significant correlation between the course of the treated disease and the size and number of abscesses was demonstrated: it was possible to define a group characterized by a slow and/or complicated course (with single abscess of the right lobe whose diameter is equal to or greater than 10 cm, or multiple abscesses). The pathogenesis of hepatic amebiasis is not yet fully understood.

Adult↗
PubMedDate not supplied

[In vivo experimental models of amebiasis].

In vivo experimental models for amebiasis have provided important information about the mechanisms of host-parasite interaction which determine the production of disease. In the laboratory, several species of rodents have been used to study the intestinal and hepatic amebiasis. For the former, the model of "washed-closed cecal loop" in guinea-pig and hamster has been useful to study the early invasive events. In gerbils we also produced early intestinal lesions by intracecal inoculation with monoxenically cultured amebas. Hamsters and gerbils have been used as susceptible animals for hepatic amebiasis, and rats and guinea-pigs as resistant animals. Morphological analysis of hepatic lesions of susceptible animals showed the role of host inflammatory cells in the process of liver damage. The resistance in the production of liver abscess in rats and guinea-pigs is due in part to the action of polymorphonuclear leukocytes in the rat and the macrophages in the guinea pigs. Complete characterization and standardization of the various models of amebiasis in rodents constitute the bases for other important biomedical studies aimed to the disease control.

Animals↗
PubMed1956

Pleuropulmonary amebiasis.

Pleuropulmonary amebiasis may be manifest without diarrhea or dysentery.In obscure lesions of the right lower lung field, one should always consider pleuropulmonary amebiasis-especially with low grade fever and moderate leukocytosis. Abscess and empyema contents should be examined promptly microscopically or kept warm to preserve the motility of the trophozoites until satisfactory examination is possible. Conservative therapy will successfully manage most cases of pleuropulmonary amebiasis. If a thorough search fails to reveal Entameba histolytica, and the diagnosis is still entertained, a medical therapeutic trial is in order.

Abscess↗
PubMedDate not supplied

Problems in recognition and diagnosis of amebiasis: estimation of the global magnitude of morbidity and mortality.

Major problems with a wide array of imperfect tests for diagnosis of amebiasis severely limit the understanding of its magnitude and epidemiology. A greater hindrance is the varied, inconsistent application of existing methods in different areas of the world. The best estimates suggest that probably 480 million people were infected with Entamoeba histolytica and 36 million developed disabling colitis or extraintestinal abscesses in 1981. At least 40 thousand deaths are attributable to amebiasis, and on a global scale, amebiasis likely ranks third among parasitic causes of death, behind only malaria and schistosomiasis. Much remains to be learned of its frequency of occurrence and epidemiology as needed improved diagnostic tools are developed.

Amebiasis↗
PubMed2001

Serum zinc and copper levels in southeastern Turkish children with giardiasis or amebiasis.

Alterations of serum zinc (Zn) and copper (Cu) concentrations are commonly found in patients suffering from gastrointestinal infections and with hepatic, renal, cardiovascular, and malignant diseases. In this study, the serum Zn and Cu levels in 20 children with giardiasis and in 40 children with amebiasis were evaluated. The serum Zn levels showed a significant decrease when compared to controls (p<0.001). After metronidazole therapy, a significant increase in Zn levels was observed (p<0.001). There was no significant difference in serum Cu levels between patients and controls before therapy. Before therapy, the serum Cu/Zn ratio in children with either giardiasis or amebiasis was significantly higher than that of the control group. After therapy, the Cu/Zn ratio was found to be back to normal. There were no significant differences in serum Zn levels and Cu/Zn ratios between children with and without diarrhea and there was no significant difference in children with or without failure to thrive. We concluded that Zn deficiency and elevated Cu/Zn ratio could be acute-phase responses to parasitic infections in children with giardiasis or amebiasis and that a successful treatment of the primary disorder will lead to complete recovery. Further studies are in progress to confirm the benefit of Zn supplementation during the acute phase of the disease, particularly in zinc-deficient regions of the world, such as in the case of Turkey.

Acute-Phase Reaction↗
PubMed1989

Declining rates of amebiasis in Los Angeles County: a sentinel for decreasing acquired immunodeficiency syndrome (AIDS) incidence?

In Los Angeles County from 1983-1988, rates of amebiasis declined 65 percent among White males 15-44 years. No such decline occurred among White females 15-44 years or White males less than 15. Reported acquired immunodeficiency syndrome (AIDS) cases in the district of highest AIDS incidence has followed the initial decline in amebiasis by four years. Amebiasis trends may be a useful predictor of human immunodeficiency virus (HIV) transmission and future rates of AIDS among gay men.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Results and experiences with several methods for the immunodiagnosis of amebiasis].

Results and experiences of some immunodiagnostic methods for amebiasis. Experiences concerning the laboratory diagnosis of invasive amebiasis are described and discussed. Technics used include the Passive Hemagglutination Test with E. histolytica antigen (Behring FRG) and sheep erythrocytes as carrier and the Indirect Fluorescence Antibody Reaction (IFAR) with corpuscular antigen prepared from cultures of E. histolytica strain HK 9. Comparatively for a part infected hamster liver (Dr. Richle strain) has been used as antigen. We conclude that IFAR with HK 9 antigen is more sensitive than the other tests. It has been proved useful in the diagnosis of extraintestinal amebiasis (antibody titer greater than or equal to 1:160).

Amebiasis↗
PubMed1985

Squamous cell carcinoma of the uterine cervix subsequent to amebiasis.

We studied the development of a well-differentiated squamous cell carcinoma of the uterine cervix five years after cervical infection with Entamoeba histolytica by documenting the findings of specimens obtained by repeated biopsies in a 69-year-old woman. To our knowledge, this is the first report of a malignant neoplasm of the uterine cervix subsequent to amebiasis. Amebiasis superimposed on malignant neoplasms of the female genital tract has been reported before. We raise the question of a possible causal relationship between amebiasis and subsequent squamous cell carcinomas of the cervix.

Aged↗
PubMedDate not supplied

Cytopathologic diagnosis of extracolonic amebiasis.

Extracolonic amebiasis must be distinguished from bacterial abscesses and neoplastic disease. Newer technology in diagnostic and interventional radiology permits such lesions to be aspirated more accurately for both diagnostic and therapeutic purposes, often averting an open surgical procedure. Paracecal and hepatic masses of one patient, who presented with fever and abdominal pain, were shown to be amebic abscesses by cytopathologic examination of material obtained by ultrasonically guided percutaneous fine needle aspiration. Another patient, who was thought to have metastatic carcinoma, died, with clinically unrecognized extensive pulmonary and hepatic amebiasis proven at autopsy. A review of this patient's sputum cytology smears showed numerous trophozoites of Entamoeba histolytica that were not recognized earlier. Cytopathologic studies of sputum and fine needle aspirates is an important means of detecting extracolonic amebiasis and distinguishing these lesions from neoplastic disease.

Amebiasis↗
PubMed1983

Cutaneous amebiasis.

An infant with cutaneous amebiasis of the vulva and amebic liver abscess is described. Epidemiologic investigations and serologic studies were crucial in establishing the diagnosis. The vulvar amebic ulcers responded dramatically to metronidazole therapy. Cutaneous amebiasis is a rare complication of Entamoeba histolytica infection which should be considered in the differential diagnosis of perineovulvar or penile ulcers. Cutaneous amebiasis may also occur on the abdominal wall surrounding a draining hepatic abscess, colostomy site, or laparotomy incision.

Amebiasis↗
PubMed1994

Amebiasis in the epidemiologic transition in Mexico: its morbidity and mortality trends in the Mexican Institute of Social Security.

Amebiasis is one of the most common parasite-related diseases and one of those with the greatest impact on health. At the Instituto Mexicano del Seguro Social (Mexican Institute of Social Security-IMSS) approximately half a million cases per year are currently treated. Of these, more than 2500 correspond to the form which invades the liver. Within the process of epidemiologic transition which Mexico is undergoing, a progressive reduction has been observed in incidence of, and mortality due to, invading amebiasis in all its clinical forms. In turn, there is a significant decrease in its fatality rate. The social and economic development and improved sanitary conditions observed in Mexico, particularly in the second half of this century, may have conditioned this process. The improvement in availability, accessibility and utilization of medical care services could also explain the reduction which has been noted in its fatality rate and mortality. The model for epidemiologic transition proposed by Omran and adapted for Mexico by Frenk, offers a plausible explanation for the changes observed in the occurrence and mortality of invading amebiasis in Mexico.

Amebiasis↗
PubMed2000

Transient appendiceal enlargement in a patient with colonic amebiasis: sonographic detection and follow-up.

A case of colonic amebiasis with no clinical signs of acute appendicitis but with sonographic visualization of an enlarged appendix is reported. As antiamebic therapy resolved the clinical signs and symptoms of the amebiasis, the sonographic appearance of the appendix returned to normal. Thus, an enlarged appendix does not necessarily indicate clinical appendicitis in patients with colonic amebiasis.

Adult↗
PubMed2003

Evaluation of dot-ELISA for serological diagnosis of amebiasis.

We improved the dot enzyme-linked immunosorbent assay (dot-ELISA) reported by Itoh and Sato, and assessed the usefulness of this test for the diagnosis of amebiasis. The sensitivity of dot-ELISA was compared with that of plate ELISA, the indirect hemagglutination test (IHA), and the indirect fluorescent antibody test (IFA) for the diagnosis of amebiasis. Of 37 serum samples from patients with documented amebiasis, 36 (97.3%) were positive by dot-ELISA. There was consistency among the results of dot-ELISA, plate ELISA, and IFA, although the positive rate of IHA was lower than that of the others (78.4%; 29 of 37 cases were positive). The specificities of dot-ELISA and plate ELISA were assessed using a total of 68 sera, collected from 38 patients infected with seven different parasites other than Entamoeba histolytica, 10 patients showing diarrhea or liver abscess without parasitic infection, and 20 healthy individuals. The two assays showed no false-positive results. There were no differences in sensitivity and specificity between dot-ELISA and plate ELISA. However, the dot-ELISA technique seems to be more feasible for clinical application than plate ELISA techniques, because the assay does not require any specific equipment.

Animals↗
PubMed1996

Progress towards an amebiasis vaccine.

Amebiasis (infection by Entamoeba histolytica) remains a major health problem in much of the developing world. Morbidity and mortality from amebic dysentery and amebic liver abscess have persisted despite the availability of effective anti-amebic therapy, suggesting a need for alternative measures of disease control. Through the application of recombinant DNA technology, several E. histolytica antigens have now been expressed in prokaryotic systems and tested in animal models as vaccines to prevent invasive amebiasis. In this review, Sam Stanley Jr discusses why a vaccine for amebiasis may be feasible, and describes the recent development of several promising recombinant E. histolytica antigen-based parenteral and oral vaccine candidates.

Journal Article↗
PubMed2006

Diagnosis of amebiasis in Bangladesh.

Diagnosis of amebiasis by microscopic identification of the parasite in stool and liver abscess pus is insensitive and unable to distinguish the invasive parasite E. histolytica from the commensal parasites such as E. dispar and E. moshkovskii. New approaches to the detection of E. histolytica are based on detection of E. histolytica-specific antigen and DNA in stool and other clinical samples. Several molecular diagnostic tests for diagnosis of amebiasis have been developed and used to diagnose E. histolytica in Bangladesh. We have compared the TechLab E. histolytica-specific antigen detection test with PCR assays and with isoenzyme analysis of cultured amebas. The PCR assays are based on amplification of the multi-copy small subunit ribosomal RNA gene of E. histolytica and E. dispar. PCR assays and antigen detection test had comparable sensitivities when performed directly on fresh stool specimens. The correlation of antigen detection with PCR assays for identification of E. histolytica was excellent. TechLab's E. histolytica- specific antigen detection test was both rapid and simple to perform, making it appropriate for use in the developing world, where amebiasis is most prevalent.

Animals↗
PubMed2005

Comparison of two methods (microscopy and enzyme-linked immunosorbent assay) for the diagnosis of amebiasis.

Diagnosis of amebiasis is usually performed on a clinical basis alone in most endemic countries having limited economic resources. This epidemiological study was conducted using modern diagnostic tests for amebiasis in the southeastern region of Turkey, an endemic area for amebiasis. The population of this study included patients with symptomatic diarrhea/dysentery attending both Yuzuncu Yil University, Van and Harran University, Sanliurfa, Turkey. A total of 380 stool specimens were collected and examined for Entamoeba by light microscopy (fresh, lugol, and trichrome staining) and stool antigen detection based- enzyme-linked immunosorbent assay (EIA) test (TechLab Entamoeba histolytica II). 24% (91/380) of stool specimens were positive for E. histolytica/Entamoeba dispar trophozoites/cysts microscopically using trichrome staining. 13% (51/380) of the stool specimens were found to be positive for E. histolytica by the EIA test, including 15% (14/91) of microscopy (+) stool specimens and 13% (37/289) of microscopy (-) stool specimens. Enteric parasites were common in these populations with 66% (251/380) of the study population harboring more than one parasite. In addition to the 13% (51/380) of patients determined to have E. histolytica by EIA, eighty-six patients (22.6%) had Blastocystis hominis, 54 (14.2%) Entamoeba coli, 44 (11.5%) Giardia lamblia, 16 (4.2%) Chilomastix mesnili, 15 (3.9%) Iodamoeba bütschlii, 12 (3.1%) Hymenolepis nana, 9 (2.3%) Endolimax nana, 9 (2.3%) Dientamoeba fragilis, and 8 (2.1%) had Ascaris lumbricoides. We concluded that E. histolytica infection was found in 13% of the patients presenting with diarrhea in Van and Sanliurfa Turkey.

Adolescent↗
PubMed1997

Present characteristics of symptomatic amebiasis due to Entamoeba histolytica in the east-southeast area of Tokyo.

Admitted medical records, from January 1988 to December 1995, of 28 symptomatic amebic patients who lived in the east-southeast area of Tokyo were studied retrospectively, in order to find the present characteristics of symptomatic amebiasis due to Entamoeba histolytica in this area. Categorized by disease, there were 14 cases of colitis, 9 cases of liver abscess, 4 cases of colitis with liver abscess, and 1 case of liver abscess with brain abscess. Patients consisted of 26 Japanese males, 0 Japanese females, 1 non-Japanese male and 1 non-Japanese female. The mean age of colitis patients and liver abscess patients was 55.4 years old and 41.3 years old, respectively. The presumed place of contraction was Japan in 64% of the patients. Forty-eight percent of male patients indicated that they engaged in homosexual or bisexual practices, and 36% of male patients who denied such sexual practices or did not answer the question had no history of marriage. Positive rate of serum titre for Treponema pallidum hemagglutination test (TPHA) and human immunodeficiency virus antibody was 42.9% and 0%, respectively. Sixty-seven percent of TPHA-positive patients indicated that they engaged in male homosexual or bisexual practices. Zymodeme patterns of E. histolytica isolated from 4 colitis patients were XIV in 1 case and II in 3 cases. Symptomatic amebiasis in the east-southeast area of Tokyo is a disease which predominantly afflicts males, especially those in their middle age, and most patients contract the disease in Japan. The high rates of patients who engaged in male homosexual or bisexual practices and the high rates of patients with positive TPHA suggest that amebiasis is likely to be sexually transmitted disease in homosexual and bisexual men in the east-southeast area of Tokyo, and zymodeme II may be the predominant type in symptomatic amebic colitis in this area.

Adult↗
PubMed1997

Identification of an epitope on the Entamoeba histolytica 170-kD lectin conferring antibody-mediated protection against invasive amebiasis.

The emergence of multidrug-resistant organisms and the failure to eradicate infection by a number of important pathogens has led to increased efforts to develop vaccines to prevent infectious diseases. However, the nature of the immune response to vaccination with a given antigen can be complex and unpredictable. An example is the galactose- and N-acetylgalactosamine-inhibitable lectin, a surface antigen of Entamoeba histolytica that has been identified as a major candidate in a vaccine to prevent amebiasis. Vaccination with the lectin can induce protective immunity to amebic liver abscess in some animals, but others of the same species exhibit exacerbations of disease after vaccination. To better understand this phenomenon, we used recombinant proteins corresponding to four distinct domains of the molecule, and synthetic peptides to localize both protective and exacerbative epitopes of the heavy chain subunit of the lectin. We show that protective immunity after vaccination can be correlated with the development of an antibody response to a region of 25 amino acid residues of the lectin, and have confirmed the importance of the antibody response to this region by passive immunization studies. In addition, we show that exacerbation of disease can be linked to the development of antibodies that bind to an NH2-terminal domain of the lectin. These findings are clinically relevant, as individuals who are colonized with E. histolytica but are resistant to invasive disease have a high prevalence of antibodies to the protective epitope(s), compared to individuals with a history of invasive amebiasis. These studies should enable us to develop an improved vaccine for amebiasis, and provide a model for the identification of protective and exacerbative epitopes of complex antigens.

Amino Acid Sequence↗