INTESTINAL AMOEBIASIS an enteric disease Made and Presented by: Asiya Fazal.
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Transcript of INTESTINAL AMOEBIASIS an enteric disease Made and Presented by: Asiya Fazal.
INTESTINALINTESTINAL AMOEBIASISAMOEBIASISan enteric diseasean enteric disease
Made and Presented by: Made and Presented by: Asiya FazalAsiya Fazal
ContentsContents IntroductionIntroduction Causative agentCausative agent EpidemiologyEpidemiology Mode of transmissionMode of transmission Clinical sign and symptomsClinical sign and symptoms Habitat of E.histolyticaHabitat of E.histolytica Life cycleLife cycle PathologyPathology DiagnosisDiagnosis TreatmentTreatment PreventionPrevention ReferencesReferences
Intestinal Intestinal AmoebiasisAmoebiasis
Intestinal Intestinal Amoebiasis,alsoAmoebiasis,also
called ‘’Amoebic called ‘’Amoebic DysenteryDysentery’’.’’.
It is a disease It is a disease characterizedcharacterized
by inflammation of by inflammation of thethe
intestines,particularly intestines,particularly the colon.the colon.
Best known species of amoeba that parasitizes human.
Global in its distribution,the incidence of infection exceeds 400 million cases
(W.H.O.)
First discovered in Russia in 1873 by Losch.
Causative agentCausative agent
The causative The causative agent of Intestinal agent of Intestinal
amoebiasis is the amoebiasis is the protozoan:protozoan:
“ “EntamoebaEntamoeba histolyticahistolytica””. .
Scientific meaningScientific meaning, , “ “Tissue dissolvingTissue dissolving””
Causative agentCausative agent
Morphologic forms:Morphologic forms:
E.histolyticaE.histolytica has has two formstwo forms..
1 - Cyst (infective 1 - Cyst (infective form)form)
2 - Trophozoite2 - Trophozoite
(active feeding form)(active feeding form)
EpidemiologyEpidemiology
10% world population is infected with 10% world population is infected with E.histolyticaE.histolytica (W.H.O) (W.H.O)
Amoebiasis is the third most common Amoebiasis is the third most common cause of death from parasitic disease. cause of death from parasitic disease. (next to malaria and schistosomes).(next to malaria and schistosomes).
In Pakistan approx.17% people become In Pakistan approx.17% people become infected with amoebic dysentery every infected with amoebic dysentery every year and the majority being children year and the majority being children (N.I.H).(N.I.H).
Mode of TransmissionMode of Transmission
Direct transmissionDirect transmission::With contaminated hands.With contaminated hands. Indirect transmissionIndirect transmission:: Contaminated food andContaminated food and
water.water. Other vital factorsOther vital factors::
Flies,vegetables,food Flies,vegetables,food handlers etc.handlers etc.
Clinical Clinical signs/symptomssigns/symptoms
Influenced by severity of infectionInfluenced by severity of infection Acute AmoebiosisAcute Amoebiosis : : Severe dysentery DehydrationSevere dysentery Dehydration (Anorexia)(Anorexia)
Blood & Mucus in faecesBlood & Mucus in faeces (Intense griping pain,frequently visits (Intense griping pain,frequently visits
latrines straining blood & mucus)latrines straining blood & mucus)
Prolapse of rectumProlapse of rectum
Clinical Clinical sign/symptomssign/symptoms
CHRONICamoebiasis
Abdominal pain
Diarrhea Or
Dysentery
Mucous withblood
In stool
Habitat of Habitat of E.histolyticaE.histolytica
E.histolytica inhibits E.histolytica inhibits large intestine.large intestine.
Trophozoite lives in Trophozoite lives in the intestinal lumen.the intestinal lumen.
May invade the May invade the mucosa, where they mucosa, where they feed on red blood feed on red blood cells and form ulcers.cells and form ulcers.
If intestinal motility If intestinal motility is rapid, amoeba is rapid, amoeba may be passed out may be passed out in liquid or in liquid or semisolid stool as semisolid stool as trophozoite.trophozoite.
If intestinal motility If intestinal motility is normal, amoeba is normal, amoeba will passed out as a will passed out as a resistant cyst.resistant cyst.
Life cycle of Life cycle of E.histolyticaE.histolytica
Quadrinucleated cystsQuadrinucleated cysts
(Infective stages)(Infective stages)
Contamination of food & HContamination of food & H22OO
Excystation in Small / large IntestineExcystation in Small / large Intestine
4 Metacyclic Forms (Amoebules)4 Metacyclic Forms (Amoebules)
Amoebules in Intestinal lumenAmoebules in Intestinal lumen
Binary Fission 8 Amoebae Binary Fission 8 Amoebae
Invade intestinal tissues (Trophozoites)Invade intestinal tissues (Trophozoites)
Asexual reproduction by binary fissionAsexual reproduction by binary fission
(Colonies of Amoebae: Increase in (Colonies of Amoebae: Increase in Population)Population)
Asexual reproduction by binary fissionAsexual reproduction by binary fission
(Increase in Population)(Increase in Population)
Last generation before encystment:Precystic Last generation before encystment:Precystic stagestage
Trophozoites Round up, Expel food Trophozoites Round up, Expel food particlesparticles
Encystment & Cysts in lumenEncystment & Cysts in lumen
Cysts in faeces Environmental Cysts in faeces Environmental
contaminationcontamination
PathologyPathology
Invasion of large Invasion of large intestine by the intestine by the action of enzymes:action of enzymes:
CysteinCystein Protease.Protease.
Becomes site of Becomes site of secondary infection secondary infection for certain bacteria for certain bacteria and viruses.and viruses.
PathologyPathology
Invasion of Intestinal mucosaInvasion of Intestinal mucosa
Multiply asexually: Binary fissionMultiply asexually: Binary fission
Invasion in deeper layers (Sub Invasion in deeper layers (Sub mucosa)mucosa)
Spread laterally Spread laterally
Flask shaped ulcers:Caecum & Ascending Flask shaped ulcers:Caecum & Ascending ColonColon
PathogenesisPathogenesis
DiagnosisDiagnosis
Diagnosis
Stool microscopy Serology Sigmoidoscopy
TreatmentsTreatments
Iodoquinol650mg
20 days
Iodoquinol650mg
20 days
Diloxanide furoate500mg
10 days
Diloxanide furoate500mg
10 days
Paromomycin500mg
10 days
Paromomycin500mg
10 days
Tinidazole2g
3 days
Tinidazole2g
3 days
Metronidazole500mg-750mg
5-10 days
Metronidazole500mg-750mg
5-10 days
TreatmentsTreatments
PreventionPrevention
Wash hands with soap & water at least 10 Wash hands with soap & water at least 10 seconds after using toilet.seconds after using toilet.
Clean bathroom & toilets often.Clean bathroom & toilets often. Avoid sharing towels.Avoid sharing towels.
Avoid eating raw vegetables.Avoid eating raw vegetables. Boil water or treat with iodine tablets.Boil water or treat with iodine tablets.
Health education and personal hygiene.Health education and personal hygiene.
ReferencesReferences
www.wikipedia.com www.sciencedirect.com Foundations of parasitology.Foundations of parasitology.