Amoebiasis
Amoebiasis is an acute infectious disease that occurs with a lesion of the large intestine, capable of passing into a generalized form. One of the so-called diseases of dirty hands.
ETIOLOGY
Amoebiasis or amoebic dysentery is caused by a dysentery or histolytic amoeba – a unicellular microorganism that is in three forms, vegetative, lumen, cysts. The disease is directly caused by the vegetative (tissue form), the luminal – carrier.
The multiplying tissue amoeba leads to abscess of the submucosal layer, followed by a breakthrough into the lumen of the intestine with the formation of ulcers of the large intestine. From the intestinal mucosa, the amoeba is able to spread hematogenically to the liver, sometimes to other organs and cause abscesses. Healed abscesses are scarred, which can lead to narrowing of the intestinal lumen, adhesions.
The incubation period is 1 week – 3 months. The mechanism of transmission is fecal-oral, water pathways, alimentary, food. Cysts are well resistant in the external environment.
symptoms
The most common manifestation of amoebiasis is dysentery colitis. It is characterized by frequent stools at first up to six times a day with the release of mucus, then up to twenty times a day and has the form of “rectal spit”, “raspberry jelly”, there are almost no fecal masses, replaced by blood and mucus. There are tenesmus – false urges to defecate. There is no increase in temperature, subfebrility is possible.
Intestinal ulcers formed by an amoeba are located in most cases in the rectum, colon and caecum. In the most severe cases, the entire intestine and even the appendix (appendix) are affected. The depth of ulcers can also be different, some can corrode the intestine through, thereby causing peritonitis – the contents of the intestine quickly enter the abdominal cavity and the processes of necrosis, severe intoxication begin.
In severe cases, there are signs of general intoxication, anorexia, nausea, vomiting. Without appropriate treatment, the disease lasts for 10 years or more with periodic exacerbations.
After the acute phase, there may be a long-term remission, then the disease returns and takes on a chronic form. During treatment, large vegetative forms decrease, form cysts.
diagnostics
Rectoromanoscopy – deep ulcers up to 10 millimeters
Laboratory – bacterial examination of feces, scraping from ulcers during rectoromanoscopy
Serological analysis of blood
It is necessary to carry out a differentiated diagnosis of dysentery, balantidiasis, oncological diseases of the large intestine.
COMPLICATIONS
Peritonitis
Intestinal perforation
Abemoma
Intestinal bleeding
Liver abscess
Protrusion of the diaphragm
Purulent pleurisy
treatment
Etiotropic therapy – Emetine, Delagil, Chloroquine, Tetracycline, Monomycin, Metronidazole, Trichopol and others. With the development of abscesses, treatment will be longer, until the abscess resolves under ultrasound control. Surgical treatment is possible in the presence of large abscesses.
All patients must be hospitalized and isolated until full recovery. Antispasmodics, eubiotics, enzymes, intravenous infusion therapy are prescribed. Physiotherapy gives a good effect (in the subacute period, without exacerbation).
Patients are discharged after clinical recovery according to the results of back-sowing, 24 hours after the withdrawal of antibiotics.
PREVENTION
A mandatory point in prevention is the identification of carriers and treatment of patients, anti–epidemic measures in the hearth, compliance with personal hygiene rules, washing products before use, sanitary and educational work in children’s institutions. Bacterial carriers are not allowed to work with food.
The medical examination of those who have been ill is carried out for one year in the office of infectious diseases.
