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PubMedDate not supplied

[Parasitic infections in pregnancy and congenital protozoan infections. Part I.: Protozoan infections].

Intestinal protozoan disease diagnosed in pregnancy is mostly controlled by symptomatic treatment. Specific therapy can be delayed until after delivery. Only severe cases, i.e. continued diarrhea leading to malnutrition of either mother or fetus, require an immediate specific drug therapy, which might be harmful to the fetus due to toxic and teratogenic potentials. Vertical transmission of intestinal protozoa has not been described. Invasive protozoan infections can be lethal to the mother making immediate drug therapy mandatory, even if the potentials of fetotoxicity or teratogenicity are known. Vertical transmission occurs independent of maternal symptoms, causing clinical disease in the child either directly after birth or during the first months of life. The knowledge of endemic regions and of the maternal travel history is essential for early diagnosis and treatment of protozoan disease in pregnancy and of congenital protozoan infections.

Adult↗
PubMed1977

[Amebiasis as surgical emergency].

Report of 2 cases of systemic complications many years after inappercept infection with amoeba histolytica. Amoebiasis being a rare affection in Switzerland, diagnosis was missed and not revealed till operation. One case with multiple liver abscesses, healed after drainage and chemotherapy with metronidazol and dehydroemetine. In the other case with colonic perforation and multiple liver abscesses combined surgical and drug therapy failed, the patient died in hepatotoxic coma. Short cut of clinics and therapy in amoebiasis, pointing out that surgery is reserved for the complications as great liver abscess, colonic perforation or fistula between abdominal and pleural cavity.

Dysentery, Amebic↗
PubMed1980

Metronidazole: proven benefits and potential risks.

Metronidazole is unique among therapies approved for trichomonas vaginitis and is useful also in the treatment of amebiasis, giardiasis and anaerobic bacterial infections. It has recently proved to be effective antibacterial prophylaxis for colon surgery. In spite of these important therapeutic properties the drug is considered risky for human use because of laboratory evidence that is it tumorigenic and mutagenic. A large excess risk of human cancer as the result of prior metronidazole exposure can probably be excluded on the basis of evidence already available. However, with the risk uncertain the drug should be restricted to patients who clearly will benefit from it and these patients should receive the drug in the minimal dose which is effective. Nitro group reduction is implicated in most of the biological properties of metronidazole including its mutagenicity. Two metabolites of the reduction of metronidazole, acetamide and N-(2-hydroxyethyl)-oxamic acid, form in the intestinal flora and can be found in the excreta of conventional rats but not of germfree rats. Thus the worrisome reaction implicated in the mutagenicity of metronidazole occurs in the flora. These metabolites produced by the flora complement those described in Ernest Bueding's laboratory. Bueding's group postulates metabolites which are mutagenic, and thus probably not yet reduced, whereas we postulate that our metabolites indicate that reduction, and thus possibly a mutagenic reaction, has already occurred. The metabolites we describe which are indicative of the reduction of metronidazole are also found in the urine of patients who take the drug. This has several possible implications which bear investigation. One is that a reactive intermediate may form in the flora and enter mammalian tissues. The other is that metronidazole is metabolized in the human to acetamide which is a carcinogen in its own right. Thus this drug,with its increasing number of useful clinical properties, continues to show laboratory properties which have uncertain implications for human risk.

Animals↗
PubMedDate not supplied

[Experimental amebiasis: effect of PGE1 on rats infested with Entamoeba histolytica].

The authors have studied the effects of PGE1 on rats (Wistar strain) infected with Entamoeba histolytica, and inoculated with PGE1 either in massive dosage and killed after 3-5 and 7 days, or with daily minimum quantity of PGE1 and killed on days 7 and 15 after inoculation. The results show an inhibition effect of PGE1 on development and survival of amoebae in the coecum of rats inoculated with the two modalities described above. The fractionated dosage gives better results and less side effects.

Animals↗
PubMed1982

An analysis of the association of gastroenteric lesions with chronic wasting syndrome of marmosets.

Retrospective pathology data from necropsies of 162 marmosets, Saguinus oedipus, were studied to determine the nature of chronic wasting syndrome, a poorly defined entity associated with a high mortality rate in many marmoset colonies. Paraffin sections of the gastroenteric organs of 116 of these marmosets were re-examined in detail; lesions were identified, quantitated, and analyzed with a method of multiple chi-square testing for possible associations between findings. Five distinct disease entities were identified: prosthenorchosis, amebiasis, paramyxovirus disease, sepsis, and chronic colitis. Lesions of several of these often occurred in the same monkey, and all but the first were associated with cachexia. Lesions of chronic colitis were crypt abscesses, mononuclear and polymorphonuclear infiltration of the lamina propria, epithelial cell atypia, karyorrhexis, and lymphoid hyperplasia. The cause of chronic colitis was not identified, nor was any explanation found for weight loss and increased susceptibility to disease.

Animals↗
PubMed2000

Immunoblot analysis of IgA antibodies to Naegleria fowleri in human saliva and serum.

The objective of this study was to evaluate the secretory IgA (SIgA) antibody response to Naegleria fowleri (Nf) in individuals living in a parasite endemic area. Saliva and serum samples were obtained from both healthy subjects and patients suffering from a respiratory illness (chronic bronchitis or rhinitis) and were analyzed by immunoblot assay. SIgA from the patients' samples recognized more intensely a greater number of Nf proteins than did SIgA from the healthy control group. The proteins more frequently recognized were those with a molecular weight of 171, 107, 102, 62, 50, 46, and 10 kDa. Some IgA antibodies recognized proteins from Nf and Entamoeba histolytica (Eh) of similar molecular weight. These results suggest that some of those antibodies could have been elicited by a previous intestinal infection with Eh. Through the common mucosal immune system the IgA B-cells activated by Eh antigens can be disseminated to all the mucosae, including the nasal mucosa. SIgA antibodies recognizing Nf proteins, induced either by specific immunization or by cross-reaction, could participate in the resistance to the infection, probably by inhibiting the adherence of Nf trophozoites to the nasal mucosa.

Amebiasis↗
PubMed1983

Prevalence of gastrointestinal parasites and urinary schistosomiasis and biting insects in an area of endemic onchocerciasis in Benue State on Nigeria.

Investigation carried out in an area of Benue State which had been found to be endemic for onchocerciasis showed that the area was also endemic for intestinal parasites especially hookworm, ascariasis and amoebiasis. 67% of the 1538 stools examined carried helminth eggs and/or protozoan cysts and 15% of the 685 urine specimens examined possessed ova of S. haematobium. Incidence of hookworm infection ascariasis and schistosomiasis was higher in the younger age groups (1-30 years) while that of amoebiasis was higher in the older age groups. Insects caught while biting humans include Tabanus, Haematopota, Stomoxys, Glossina and Culicoides species, a substantial preportion of which was engorged with fresh blood.

Age Factors↗
PubMed1982

Dientamoeba fragilis: a gastrointestinal protozoan infection in adults.

Dientamoeba fragilis is a protozoan parasite of the large intestine of man. Individuals with infection may be asymptomatic or have gastrointestinal and systemic symptoms. We report a patient with symptomatic D. fragilis infection and negative extensive laboratory and radiological workup, with resolution of symptoms after diiodohydroxyquin therapy. No parasites were detected in three follow-up stool examinations. We then undertook retrospective study to define and describe further clinical symptoms in adults with this infection by analysis of data from medical records of 50 subjects with this parasite.

Abdomen↗
PubMed1988

Recurrence of hepatic amebiasis after successful treatment with metronidazole.

A patient with an amebic liver abscess had an incomplete response to an initial course of metronidazole, but subsequently responded to a prolonged course of the agent. Recurrence of disease in the contralateral hepatic lobe responded to chloroquine along with a luminicide. We took the initial failure of metronidazole to be secondary to either the advanced nature of the disease or the development of partial resistance to metronidazole. The recurrence was the result of reinfection of the liver by persistent organisms in the bowel, emphasizing the importance of giving a lumicide in the initial treatment of this lesion.

Adult↗
PubMed1996

[Post-partum malignant amebic colitis. Apropos of a case].

A 26-year old female developed acute fulminant amoebic colitis during the post-partum period, successfully managed by subtotal colonic resection without anastomosis. Fulminant transmural amoebic colitis is a rare life-threatening complication of invasive bowel amebiasis. Pregnancy, delivery, diabetes mellitus and immunodeficiency are the main risk factors. At pathologic examination, bowel wall necrosis can be seen with amoebae present in the lumen of capillary vessels. The diagnosis of amoebic colonic perforation is difficult, especially in a non-endemic area. Conservative surgical management is required in non-perforated forms. If perforated, the bowel must be resected, limited to macroscopic lesions.

Adult↗
PubMed1977

Colo-rectal biopsy in inflammatory bowel disease.

The term inflammatory bowel disease (IBD) is viewed as all-inclusive, covering the full panoply of intestinal disorders in which inflammatory changes are a prominent feature, including those of infectious, toxic, and intrinsic origin as well as the idiopathic entities ulcerative colitis and Crohn's disease. This chapter describes and discusses those aspects of colo-rectal biopsy in IBD which can help pathologists make optimal interpretations. The areas covered are: 1) methods used to prepare biopsy specimens for study, 2) normal histologic findings and common artefacts, 3) basic pathologic changes occurring in IBD, 4) a general approach to differential diagnosis in IBD, and 5) discussion of the various individual forms of IBD. The importance of full and reliable information exchange between the endoscopist and pathologist is stressed. Special attention is given to features in biopsy specimens which help in differentiating between ulcerative colitis and Crohn's disease. Other entities discussed are bacterial dysenteries; gonococcal proctitis; tuberculosis; Whipple's disease; amebiasis; balantidiasis; schistosomiasis; cryptosporidiosis; lymphopathia venereum; cytomegalovirus infection; histoplasmosis; antibiotic colitis; IBD due to cytotoxic drugs (5-FU), heavy metals, and foodstuffs; irradiation colitis; ischemic colitis; solitary ulcer syndrome; diverticulitis; and colitis secondary to obstruction. The term pseudomembranous enterocolitis is also considered.

Biopsy↗
PubMed2000

Socioeconomic status, clinical features, laboratory and parasitological findings of hepatic amebiasis patients--a hospital based prospective study in Bangladesh.

Socioeconomic status, clinical, laboratory and parasitological features of 31 hospitalized amebic liver abscess (ALA) and 8 amebic hepatitis (AH) patients were studied. Thirty-seven (94.9%) of the total 39 cases were from low socioeconomic class and 2 (5.1%) were from middle class (p<0.001). Sixteen (51.6%) ALA and 5 (62.5%) AH patients were admitted with duration of disease for 3 weeks or more. Twenty-one (67.7%) ALA and 3 (37.5%) AH cases gave no previous history of diarrhea or dysentery. Epigastric pain was the predominant symptoms in 71% patients compared to high fever (19.4%), nausea and vomiting (9.7%). Neutrophilic leukocytosis was found in 9 (29.0%) ALA and 2 (25%) AH cases. Raised alkaline phosphatase was the predominant abnormal liver function test found elevated in 22 (71.0%) ALA and 5 (62.5%) AH cases. Three (7.7%) of the 5 (12.8%) microscopy positive stool samples yielded growth of Entamoeba histolytica in culture. The right lobe was involved in 28 (90.3%) ALA cases; 29 (93.5%) patients had single abscess. Bacterial super infection was observed in 1 (12.5%) abscess, reactive changes in right lung was observed in 6 (19.4%) ALA and 1 (12.5%) AH cases. Ascaris lumbricoides was the predominant associated intestinal parasite.

Adolescent↗
PubMed1992

Anti-amoebic antibody levels in gastro-intestinal disorders.

Serum anti-amoebic antibody levels were studied in 91 cases having clinical presentation of bowel disorders and 31 cases of control. Anti-amoebic antibody was positive in significant dilutions in 38 cases (31.15%) in total comprising 9 cases out of 22 cases showing presence of Ent histolytica cyst in stool, 13 cases who were positive for ova, parasite and cysts other than Ent histolytica in stool and 16 cases out of 70 cases with negative stool findings. It was positive in 5 cases out of 9 diagnosed cases of amoebic liver abscess. Assessment of immunoglobulin levels in amoebic liver abscess cases revealed high levels of immunoglobulin G and immunoglobulin M.

Amebiasis↗
PubMed1995

Fulminant amebiasis: a clinical evaluation.

Two patients with fulminant amebic colitis with colon perforation and concomitant liver abscess were collected over the last 5 years. One patient underwent emergency laparotomy to treat amebic cecal perforation. Diverted ileostomy saved his life. The ileostomy was successfully reversed 6 months later. The other patient underwent 4 laparotomies with more invasive procedures in less than 1 month due to sequential complications of amebiasis. Colon resection with enterostomy miraculously allowed him to survive. In comparison with the latter, who underwent more aggressive surgery and experienced more catastrophic complications, the former with conservative surgery had a smoother clinical result. Thus, conservative operation for colon perforation due to amebiasis is recommended. Besides, thanks to the alertness of doctors, the favorable age of the patients, the advent of new antiamebic and antimicrobial agents, excellent hyperalimentation, the great improvement in medical facilities and postoperative care, the two critical patients eventually survived after several operations, and had a better outcome as compared with the high mortality rate of 87.5% in our hospital 2 decades earlier.

Adult↗
PubMed1998

Mucosal immunogenicity of a holotoxin-like molecule containing the serine-rich Entamoeba histolytica protein (SREHP) fused to the A2 domain of cholera toxin.

One strategy for the induction of mucosal immune responses by oral immunization is to administer the antigen in conjunction with cholera toxin. Cholera toxin consists of one A polypeptide (CTA) which is noncovalently linked to five B subunits (CTB) via the A2 portion of the A subunit (CTA2). Coupling of antigens to the nontoxic B subunit of cholera toxin may improve the immunogenicity of antigens by targeting them to GM1 ganglioside on M cells and intestinal epithelial cells. Here, we describe the construction of a translational fusion protein containing the serine-rich Entamoeba histolytica protein (SREHP), a protective amebic antigen, fused to a maltose binding protein (MBP) and to CTA2. When coexpressed in Escherichia coli with the CTB gene, these proteins assembled into a holotoxin-like chimera containing MBP-SREHP-CTA2 and CTB. This holotoxin-like chimera (SREHP-H) inhibited the binding of cholera toxin to GM1 ganglioside. Oral vaccination of mice with SREHP-H induced mucosal immunoglobulin A (IgA) and serum IgG antiamebic antibodies and low levels of mucosal anti-CTB antibodies. Our studies confirm that the genetic coupling of antigens to CTA2 and their coexpression in E. coli can produce holotoxin-like molecules that are mucosally immunogenic without the requirement for supplemental cholera toxin, and they establish the SREHP-H protein as a candidate for evaluation as a vaccine to prevent amebiasis.

Animals↗
PubMed1975

Monoxenic and axenic cultivation of carrier and patient strains of Entamoeba histolytica.

All of five strains of Entamoeba histolytica, isolated from symptomatic cases of amoebiasis, could be adapted to axenic growth on the TP-S-1 medium of Diamond (1968). Four axenic strains were started from amoeba-Crithidia cultures; one could be axenized directly after isolation from a case of cutaneous amoebiasis. Attempts to monoxenize, resp. axenize strains, isolated from Dutch, asymptomatic carriers, were less successful. Only three out of ten strains could be submitted to bacteria-free growth. These three strains, however, originated probably from a recent case of intestinal amoebiasis. The results, suggesting that highly virulent strains can be easier cultivated bacteria-free than those with low or no virulence, are further discussed. The yield of axenic amoebae per tube fluctuates largely depending on many factors such as the strain, the number of transfers (i.e. degree of establishment), the quality of Panmede liver digest and serum in the TP-S-1 medium, and the care of manipulating the cultures. For optimal growth, a more acid medium was required in an amoeba-Crithidia culture than in an axenic culture. Multinucleated, giant amoebae were frequently observed in axenic cultures.

Amebiasis↗
PubMed1985

A mouse model for Entamoeba histolytica infection.

2 strains of Entamoeba histolytica, SAW 760 and SAW 408 (non-invasive zymodeme IX and invasive zymodeme II respectively, Sargeaunt & Williams 1979) were administered intra-intestinally to 15 inbred and 3 outbred strains of mouse. All were known to be free of the mouse amoeba E. muris. During the investigation, all animals were maintained in plastic film isolator units, under gnotobiotic conditions. Both zymodemes were found to be capable of infecting all 18 strains of mice for varying periods of time and both were capable of invading the gut mucosa in genetically susceptible strains. Mortality was high in some of the immunologically deprived strains, particularly with the more invasive strain of amoeba. 4 mouse strains: DBA/2, MRL, NZB, C57BL/6 bg, were found to be particularly good hosts to SAW 760.

Amebiasis↗
PubMed1981

Amoebiasis in an urban black population.

Amoebiasis is a common cause of dysentery and liver abscess at Baragwanath Hospital, Johannesburg. Forty-eight adult patients with amoebiasis were diagnosed during the 8-month period 1 December 1979 to 31 July 1980. There was a high incidence of extra-intestinal complications (38%) and a high mortality rate (12.5%) in this series. The importance of early surgery in fulminating dysentery which has not responded to amoebicidal therapy is emphasized. The need for early diagnosis is crucial, since failure to consider the possibility of the presence of amoebiasis may result in serious complications. This study demonstrates that endemic 'pockets' of amoebiasis are probably present in Soweto, Johannesburg. It is suggested that those involved in the preparation or handling of food for public consumption be clinically examined, and their stools examined for cysts of Entamoeba histolytica.

Amebiasis↗